Acute Pancreatitis

Question 1

How does a patient with acute pancreatitis present?

Answer 1

1. epigastric pain relieved sitting forwards
2. nausea and vomitting
3. Jaundice

Question 2

What is ‘Grey turner’s sign’

Answer 2

bruising in the left flank

Question 3

What is ‘Cullen’s sign’

Answer 3

peri umbilical discoloration

Question 4

Name ALL of the causes of acute pancreatitis?

Answer 4

1. Gallstones
2. Ethanol
3. Trauma
4. Steroids
5. Mumps
6. Autoimmune
7. Scorpion
8. Hyperlipidaemia
9. ERCP
10. Drugs

Question 5

What are the 3 most common causes?

Answer 5

1. Alcohol
2. Gall stones
3. ERCP

Question 6

Which medications can cause pancreatitis?

Answer 6

1. immunosupressants - Azathiprine/Mesalazine
2. Diuretics - Furosemide, thiazide
3. Steroids
4. Sodium valporate

Question 7

Initial screening of pancreatitis

Answer 7

Glasgow score
P – Pa02 < 60
A – Age > 55
N – Neutrophils (WBC > 15)
C – Calcium < 2
R – uRea >16
E – Enzymes (LDH > 600 or AST/ALT >200)
A – Albumin < 32
S – Sugar (Glucose >10)

Question 8

What are the different interpretations of the Glasgow score?

Answer 8

< 2 = mild
2 = moderate
> 3 = severe

Question 9

What is the immediate management of Acute Pancreatitis?

Answer 9

1. ABC with O2
2. Resus with IV fluid and treat hypovolaemia ( v important)
3. Analgesia
4. Nil by mouth and early feeding