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GI > Acute pancreatitis > Flashcards

Acute pancreatitis Flashcards

1
Q

GET SMASHED.

what is the G?

A

Gallstones

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2
Q

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what is the E?

A

ethanol

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3
Q

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what is the T?

A

trauma

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4
Q

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what is the 1st S?

A

steroids

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5
Q

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what is the M

A

mumps (coxsackie B)

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6
Q

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what is the A?

A

autoimmune

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7
Q

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what is the S?

A

scorpion

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8
Q

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what is the H?
-4

A

Hypertriglyceridaemia
Hyperchylomicronaemia Hypercalcaemia
Hypothermia

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9
Q

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what is the 2nd E?

A

ERCP

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10
Q

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what is the D?
-8

A

drugs

azathioprine
mesalazine*
didanosine
bendroflumethiazide furosemide
pentamidine
steroids
sodium valproate
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11
Q

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

A

mesalazine

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12
Q

how many cases are idiopathic?

give %

A

20%

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13
Q

how many cases are are mild to moderate?

give %

A

80%

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14
Q

how many cases are severe/life-threatening?

give %

A

20%

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15
Q

why is there fat necrosis?

A

lipase

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16
Q

why is there oedema?

A

inflammation makes BVs leaky

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17
Q

what causes destruction of pancreatic tissue?

A

proteolytic enzymes

18
Q

how do gallstones cause acute pancreatitis?

- give step by step process

A

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.

19
Q

how does alcohol case acute pancreatitis?

- 3

A

↑pancreatic exocrine secretion

↑contraction of the sphincter of Oddi

membrane damage.

20
Q

what is the general pathophysiology of acute pancreatitis?

A

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

21
Q

symptoms of acute pancreatitis?

- 2 main ones

A

severe epigastric pain

vomiting is common

22
Q

where does pain radiate to?

A

back

23
Q

what is Cullen’s sign?

A

periumbilical discolouration

24
Q

what is Grey-Turner’s sign?

A

flank discolouration

25
Q

common signs?

-4

A

epigastric tenderness
ileus
low-grade fever
tachycardic

26
Q

what will ileus sounds like on auscultation?

A

no bowel sounds

27
Q

main bloods tests?
-2

which blood test is more specific for acute pancreatitis?

A

↑↑↑ Amylase
↑↑↑ Lipase

Lipase more specific

28
Q

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

A

US

29
Q

1st line immediate management?

  • after abcde
  • 2 things
A

IV fluids + opioids

30
Q

what is the surgery for gallstone?

A

cholecystectomy

31
Q

what is the surgery for Obstructed biliary system?

A

ERCP

32
Q

what is the surgery for infected necrosis?

- 2

A

radiological drainage or necrosectomy

33
Q

what is the surgery for Pseudocysts?

A

cystogastrostomy

34
Q

what is the surgery for pancreatic abscess?

A

incise + drain

35
Q

what can a pseudocyst complicate to?

A

abscess

36
Q

what can peripancreatic fluid complicate to?

A

pseudocysts

37
Q

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

A

helps lactic acidosis

38
Q

what is the respiratory complication of acute pancreatitis?

A

Acute respiratory distress syndrome

39
Q

what do you need to diagnose acute pancreatitis?

-2

A

high amylase/lipase + positive Hx

40
Q

you want to check for gallstones quickly?

1st line Ix

A

US

GI (25 decks)

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