Acute Pancreatitis

Question 1

CRP’s peak value raises within ___ hours

Answer 1

72 hours

Question 2

What is CRP?
Where is it synthesised?
When is it raised?

Answer 2

• Acute phase reactant
• synthesized by liver
• raised in inflammation

Question 3

CRP value over 15mg/dL at 48 H is a good indicator of? [Acute pancreatitis complication]

Answer 3

Necrotising Pancreatitis

Question 4

Diagnostic criteria of Acute pancreatitis based on the AP 2006 guidelines (Need 2/3)

Answer 4

At least 2/3 of the following:

• Characteristic abdominal pain (Epigastric pain radiating to the back)
• elevation of 3x upper limit of serum amylase and lipase
• Characteristic features on CECT, MRI, US

Question 5

CT findings of AP. (4)

Answer 5

• local/ Diffuse parenchymal enlargement
• changes in density (d/t edema)
• indistinct pancreatic margins (d/t inflammation)
• retroperitoneal fat stranding
• Calcification (suggest CP)

Question 6

Glasgow Imrie is used to predict the severity of acute pancreatitis.

What is the limitation of the scoring?

What is the cutoff score before it is considered severe acute pancreatitis?

Mnemonic for the components of the scoring system? (PANCREAS)

Answer 6

• It can only be used at 48 Hours
• 3 and above is severe acute pancreatitis
• PaO2< 70mmHg
• Age> 55 Years
• Neutrophils (WCC> 15)
• Ca2+ < 2 mmol/L
• Renal function: Urea>16mmol/L
• Enzymes LDH> 600 IU/L
• Albumin< 32 g/L
• Sugar (glucose>10mmol/L)