acute pancreatitis

Question 1

define acute pancreatitis

Answer 1

sudden inflammation and haemorrhaging of pancreas due to its own digestive emzymes

Question 2

what are the causes of acute pancreatitis?

Answer 2

IGETSMASHED
I- diopathic
G- allstones- 50% of all acute cases
E- thanol- 80% of all chronic causes
T- rauma
S- teroids
M- umps
A- utoimmune
S-corpion venom/ spider bite
H- ypercalcaemia/ hyperlidiaemia
E- RCP
D-rugs

Question 3

describe gallstone pathology

Answer 3

1. gallstones gets trapped at end of biliary system
2. blocks flow of bile and pancreatic juice into duodenum
3. reflux of bile and prevention of enzyme secretions leads to inflammation

Question 4

describe the pathology behind alcohol caused acute pancreatitis

Answer 4

1. Alcohol directly toxic to pancreatic cells
2. inflammation

Question 5

describe alcoholic pathophysiology for acute pancreatitis

Answer 5

1. sudden onset of pancreatic inflammation
2. auto digestion of gland ( reversible ) and nearby structures
3. Haemorrhage + turners sign
4. deranges normal pancreatic function– hyperglycaemia

Question 6

what are the symptoms of acute pancreatitis?

Answer 6

• sudden severe epigastric pain radiating to back
  -jaundice
• pyrexia
• steatorrhea
• grey- turners syndrome
• Cullens sign
• nausea and vomiting
  -tachycardia

Question 7

how is acute pancreatitis diagnosed?

Answer 7

1. bloods- high serum amylase, high serum lipase ( more specific) , high CRP
2. urinalysis- high urinary amylase
3. abdo ultrasounds, CT, MRI

Question 8

In order for a diagnosis to be made for acute pancreatitis, what must you have?

Answer 8

at least two of these:
- characteristic symptoms
- high amylase/ lipase
- radiological evidence

Question 9

what are the two acute pancreatitis scoring systems?

Answer 9

• APACHE 2- assess severity within 24hrs
  -Glasgow score- prediction of severe attack- only after 48 hrs

Question 10

what is the treatment for acute pancreatitis?

Answer 10

acute emergency prognosis
- Nil by mouth- using GN tube
- IV fluid
- analgesia
- antibiotics prophylaxis
- treat gallstones if present
- treat complications

Question 11

what are the complications associated with acute pancreatitis?

Answer 11

SIRs- systemic inflammatory response syndrome
2 or more of:
- tachycardia
-tachypenia
- pyrexia
- high wcc