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Gastroenterology > Acute pancreatitis > Flashcards

Acute pancreatitis Flashcards

1
Q

What are the causes of acute pancreatitis?

A

I GET SMASHED

I - iatrogenic
G - gallstones
E - ethanol
T - trauma
S - scorpion/spider bites
M - mumps
A - autoimmune
S - steroids
H - hypercalcaemia, hyperlipidaemia
E - ERCP
D - drugs

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2
Q

What drugs increase the risk of pancreatitis?

A

Valproate
Azathioprine
Thiazide diuretics
Tetracyclines
Mesalazine
Oestrogen
Sitagliptin

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3
Q

What are the risk factors for acute pancreatitis?

A

Increasing age
Afro-carribbean ethnicity
Obesity
Type 2 diabetes
Family history

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4
Q

What are the symptoms of acute pancreatitis?

A

Severe RUQ, LUQ or epigastric pain
Pain that radiates to the back
Nausea and vomiting
Anorexia
Steatorrhoea (seen in acute on chronic)
Poor urinary output

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5
Q

What are the clinical signs of acute pancreatitis?

A

Abdominal distension
Guarding
Tachycardic
Hypotension
Cullen’s sign
Grey Turner’s sign
Fox’s sign

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6
Q

What is cullen’s sign?

A

Bruising around the umbilicus, that indicates periumbilical bleeding secondary to intraperitoneal haemorrhage

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7
Q

What is Grey Turner’s sign?

A

Bruising or discoloration of the flanks - indicates a retroperitoneal bleed

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8
Q

What is Fox’s sign?

A

Bleeding over the inguinal ligament secondary to retroperitoneal haemorrhage

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9
Q

What is the diagnostic criteria for acute pancreatitis?

A

2 out of 3 of the following features:
- Clinical features consistent with pancreatitis
- Elevation of serum amylase or lipase
- Radiological features consistent with pancreatitis e.g inflammation on CT

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10
Q

What are the primary diagnostic investigations for acute pancreatitis?

A

Serum amylase (3 times upper limit of normal)
Serum lipase - more specific

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11
Q

What investigations may be used to score severity of acute pancreatitis?

A

FBC
U&E
LFTs (gallstone related pancreatitis)
ABG
Serum glucose
Serum LDH
Serum calcium

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12
Q

What is the Glasgow score?

A

A score to determine severity of acute pancreatitis
- If a patient has 3 or more points within the first 48 hours they should be considered for high-dependency care

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13
Q

What are the components of the Glasgow score?

A

pO2 < 8
Age > 55
WCC > 15
Calcium < 2
Urea > 16
AST > 200
Albumin < 32
Blood glucose > 10

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14
Q

What is the first line management of acute pancreatitis?

A

IV fluid resuscitation
Catheterisation
Oxygen supplementation
Oral or enteral feeding

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15
Q

What is the specific treatment of gallstone pancreatitis?

A

ERCP
Cholecystectomy

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16
Q

What are the complications of acute pancreatitis?

A

Peripancreatic fluid collection
Pancreatic pseudocyst
Pancreatic abscess
Haemorrhage
Necrotising pancreatitis
Chronic pancreatitis
Hypocalcaemia
Hypovolaemic shock

Gastroenterology (23 decks)

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