Acute pancreatitis Flashcards
Character of pain in AP
Stabbing
Radiation of pain in AP
To back
Pain in AP worsens on
Lying flat
Pain in AP relieved on
Curling forward in foetal position
Grey turner sign in AP
Bruising along flanks
Cullen’s sign in AP
Bruising along peri-umbilical cord
I GET SMASHED
- idiopathic
- gallstones
- ethanol
- trauma
- steroids
- mumps
- autoimmune - SLE
- scorpion bite
- hypercalcaemia/hyperglyceridemia/hypothermia
- ERCP
- drugs (FAT SHEEP)
FAT SHEEP drugs
- furosemide
- azathioprine/asparaginase
- thiazides/tetracyclines
- statins/sulfonamides/sodium valproate
- hydrochlorothiazide
- estrogens
- ethanol
- protease inhibits & NRTIs
Gallstones pancreatitis epi (age, gender)
- women
- elderly
GS pancreatitis pathogenesis
- block ampulla of Vater
- bile reflux —> pain
- enzymes reflux —> inflammation
Alcohol pancreatitis epi (age, gender)
- men
- young
RFs for AP
- > 70
- obese
- heavy smoker/drinker
- FH
An increase of amylase by how much over 24hrs is found in AP
3 fold
Why is an increase of lipase is more preferable than an increase in amylase
More sensitive
0-1 is what on the Glasgow Imrie Criteria for AP
Mild
2 is what on the Glasgow Imrie Criteria for AP
Moderate
3 and > is what on the Glasgow Imrie Criteria for AP
Severe
USS detects for what
Gallstones
MRCP looks for
Obstructive pancreatitis
Why is ERCP preferred to MRCP
Can be therapeutic
CT can look for what two complications of pancreatitis
- pseudocytes
- necrotising pancreatitis
Location of pseudocytes
Surface of pancreas
What type of fluids are administer in AP
Fluid with crystalloids
Complications of CP
- AP complications
- loss of endocrine & exocrine function
- damage to duct systems
Tx CP
- abstain from alcohol & smoking
- replace pancreatic enzymes
- analgesia
- insulin
- ERCP
- surgery
(Supportive care + manage underlying cause)
