acute pancreatitis

Question 1

diagnosis of pancreatitis is made if there is presence of at least two of the following

Answer 1

1. characteristic abdominal pain (usually central and epigastric, often described as intense boring pain that radiates to the back, which)
2. biochemical evidence of pancreatitis (serum amylase or lipase elevated more than 3 times the upper limit of normal)
3. radiographic evidence of pancreatitis on imaging

Question 2

causes of pancreatitis

Answer 2

gallstones
prolonged excessive alcohol consumption
drugs
complication of ERCP
infections, hyperlipidaemia, hypercalcaemia, trauma, genetic mutations or congenital abnormalities, vasculitis or cancer

Question 3

management of acute pancreatitis

Answer 3

manage in hospital
fluid administration and analgesia - morphine or fentanyl
antiemetic therapy
cholecystectomy for gallstone pancreatitis

Question 4

late complications of acute pancreatitis

Answer 4

may occur weeks to months after the first episode
pseudocysts generally resolve spontaneously
pancreatic fistulas
necrosis
exocrine and endocrine insufficiencies

Question 5

causes of pancreatic exocrine insufficiency

Answer 5

pacreatectomy
chronic pancreatitis
cystic fibrosis
obstruction of the main pancretic duct caused by tumours
reduced stimulation of paancreatic enzymes after gastric surgery due to coeliac disease
type 2 diabetes
IBD

Question 6

pancreatic exocrine deficiency is diagnosed based on

Answer 6

clinical context of the patient (eg. patients with chronic pancreatitis) and symptoms (eg. loose foul smelling bowel movements, weight loss)
lab markers indicative of malnutrition

Question 7

diagnosis of pncreatic exocrine deficiency

Answer 7

available tests have limited specificity and sensitivity
a therpepeutic trial of pancreatic enzyme supplments can help to confirm the diagnosis of PE, assess the effect of supplimentation of symptoms and nutritional status