Acute pancreatitis Flashcards by cerchia N

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what is the G?

Gallstones

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what is the E?

ethanol

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what is the T?

trauma

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what is the 1st S?

steroids

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what is the M

mumps (coxsackie B)

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what is the A?

autoimmune

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what is the S?

scorpion

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what is the H?
-4

Hypertriglyceridaemia
Hyperchylomicronaemia Hypercalcaemia
Hypothermia

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what is the 2nd E?

ERCP

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what is the D?
-8

drugs

azathioprine
mesalazine*
didanosine
bendroflumethiazide furosemide
pentamidine
steroids
sodium valproate

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which drugs used for UC is 7x more likely to cause acute pancreatitis than sulfasalazine?

mesalazine

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how many cases are idiopathic?

give %

20%

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how many cases are are mild to moderate?

give %

80%

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how many cases are severe/life-threatening?

give %

20%

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why is there fat necrosis?

lipase

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why is there oedema?

inflammation makes BVs leaky

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what causes destruction of pancreatic tissue?

proteolytic enzymes

how do gallstones cause acute pancreatitis?

- give step by step process

gallstone blocks duct, pressure increases and enzyme-rich fluid accumulates, ∴ lipase builds up –>fat necrosis –> this injured tissue trigger inflammation –> BVs leaky so oedema builds –> oedema further compromises blood flow –> ischaemia and even more injury.

how does alcohol case acute pancreatitis?

- 3

↑pancreatic exocrine secretion

↑contraction of the sphincter of Oddi

membrane damage.

what is the general pathophysiology of acute pancreatitis?

pancreatic enzymes auto-digest the pancreatic tissue (damage) –>
inflammation (more damage) makes BVs leaky –> fluid shifts –> oedema –> oedema compromises blood flow more –> ischaemia

symptoms of acute pancreatitis?

- 2 main ones

severe epigastric pain

vomiting is common

where does pain radiate to?

back

what is Cullen’s sign?

periumbilical discolouration

what is Grey-Turner’s sign?

flank discolouration

common signs? | -4

epigastric tenderness ileus low-grade fever tachycardic

what will ileus sounds like on auscultation?

no bowel sounds

main bloods tests? -2 which blood test is more specific for acute pancreatitis?

↑↑↑ Amylase ↑↑↑ Lipase Lipase more specific

which imaging is 1st line to guide treatment by finding out the cause?

1st line immediate management? - after abcde - 2 things

IV fluids + opioids

what is the surgery for gallstone?

cholecystectomy

what is the surgery for Obstructed biliary system?

ERCP

what is the surgery for infected necrosis? | - 2

radiological drainage or necrosectomy

what is the surgery for Pseudocysts?

cystogastrostomy

what is the surgery for pancreatic abscess?

incise + drain

what can a pseudocyst complicate to?

abscess

what can peripancreatic fluid complicate to?

pseudocysts

through what mechanism/ what reason does giving fluids help with pain possibly?

helps lactic acidosis

what is the respiratory complication of acute pancreatitis?

Acute respiratory distress syndrome

what do you need to diagnose acute pancreatitis? | -2

high amylase/lipase + positive Hx

you want to check for gallstones quickly? 1st line Ix