acute pancreatitis Flashcards
what are the most common etiologies associated with pancreatitis ?
GETSMASHEED
what are the drugs associated with pancreatitis ?
azathioprine
NSAIDS
diuretics
what typeof pancreatitis is associated with ach gender ?
alcohol associated in males
biliary in females
what is the most common gene implicated in pancreatitis ?
CFTR gene
what is the clinical presentation associated with pancreatitis ?
epigastric pain that radiates to the back and is relieved by leaning forward
knifelike pain
what are the features seen on examination in pancreatitis patients ?
cullen’s sign
grey turner sign
what are the differentials of pain that radiates to the back ?
pancreatitis
aortic dissection
aortic aneurysm
peptic ulcer disease
acute cholecystitis
mesenteric ischemia
myocardial infarction
what are the required criteria for the diagnosis of pancreatitis ?
2 of the 3
abdominal pain consistent with acute pancreatitis
biochemical evidence of pancreatitis
lab findings
what are the investigations used for pancreatitis ?
serum amylase three times the fold is diagnostic
serum lipase is more accurate
liver function test
cc reactive
what are the tests to determine the presence of hypovolemia ?
BUN of more than 20
hematocrit over 44%
creatinine level morre than 1.8
what is the first line imaging modality ?
US
what can be seen on x ray that denotes pancreatitis ?
sentinel loop sign
what is indicative of necrosis in imaging of pancreatitis ?
gas in peripancreatic fluid
what is the recommended radiological investigation for idiopathic acute pancreatitis ?
endoscopic US
what is used to assess the severity of pancreatitis in thee first 48 hours of admission ?
modified glasgow criteria
Po2
Age >55
Neuutrophils
Calcium is low
R enal function
Enzymes LDH or AST
Albumin
Sugar
what are the types of peripancreatic collection ?
less than 4 weeks then it is Acute pancreatic fluid collection
more than 4 weeks then it is a pseudocyst
what are the systemic complications of acute pancreatitis ?
DIC
ARDS
hyperglycemia
hypocalcemia
abdominal compartment syndrome
bowel infarction or perforation
what are the local complications of acute pancreatitis ?
pancreatic necrosis
pancreatic pseudocystwh
what is the management of a pancreatic pseudocyst ?
usually nothing
if it persists over 6 weeks
then surgical drainage into the stomach
how is feeding managed in pancreatitis ?
mild symp - oral feeding 3ady
NPO only in patients with nausea and vomiting
eenteral over parenteral nutrition
what to do if enteral nutrition is not tolerated ?
parenteral nutrition and give glucosew
when is drainage and debridement indicated in pancreatitis ?
in patients with infected necrosis
