Acute Pancreatitis

Question 1

What is acute pancreatitis

Answer 1

The inflammation of the pancreatic parenchyma Q

Question 2

What are two features pancreatitis

Answer 2

Fat necrosis

Oedema

Question 3

What features are common in a blood test for someone with acute pancreatitis

Answer 3

High Serum amylase levels

Raised lipase enzymes

Question 4

What are the main causes for acute pancreatitis

Answer 4

Gall stones
Alcohol
Trauma

Question 5

What is the pathological reason for the inflammation in acute pancreatitis from gall stones

Answer 5

The destructive effects of built up activated pancreatic enzymes

Question 6

What is the pathological reason for the inflammation in acute pancreatitis from trauma/drugs

Answer 6

Acinar cells can get damaged

Question 7

What is the pathological reason for the inflammation in acute pancreatitis from alcohol

Answer 7

Alcohol increases enzyme secretion which has destructive effects on the pancreas and creates leaky vessels

Question 8

Why do you get fat necrosis in acute pancreatitis

Answer 8

Fatty-tissue necrosis is probably caused by lipase (one of the few pancreatic enzymes that need no activation) after an abrupt effusion of zymogens from peripheral acinar cells into the interstitial space

Question 9

What group of enzymes causes fat necrosis in acute pancreatitis

Answer 9

Lipolytic enzymes

Question 10

What does the released fat in fat necrosis do?

Answer 10

It binds calcium causing hypocalcaemia in the body

Question 11

What group of enzymes destroy acinar tissue, blood vessels and islets of langerhaans in acute pancreatitis

Answer 11

Proteolytic enzymes

Question 12

What happens to the body if the islets of langerhaans are destroyed

Answer 12

Hyperglycaemia as blood glucose will rise.

Question 13

What are the signs and symptoms of acute pancreatitis

Answer 13

Epigastric pain that radiates to back
Anorexia
Nausea and Vomitting

Question 14

What are the features of grey turners sign

Answer 14

Grey Turner’s sign refers to bruising of the flanks, the part of the body between the last rib and the top of the hip. The bruising appears as a blue discoloration

Question 15

What is Grey turner’s sign important in acute pancreatitis

Answer 15

It can predict a severe attack of acute pancreatitis

Question 16

How long down Grey Turner’s sign take to devlop

Answer 16

24-48 hours

Question 17

What is Cullen’s signs

Answer 17

Cullen’s sign is superficial edema and bruising in the subcutaneous fatty tissue around the umbilicus

Question 18

What is Cullen’s sign important in from an acute pancreatitis perspective

Answer 18

It can predict a severe attack of acute pancreatitis

Question 19

What investigations should be carried out for acute pancreatitis

Answer 19

Bloods - for raised serum amylase and lipase
Ultrasound - to detect cause eg gall stones
CT - to rule out complications

Question 20

What are complications associated with acute pancreatitis (x6)

Answer 20

Haemmorhage
Disseminated intravasular coagulation 
Acute respiratory distress syndrome 
Multiorgan failure 
Necrosis 
Acute renal failure

Question 21

What is Disseminated intravasular coagulation

Answer 21

Disseminated intravascular coagulation is a condition in which small blood clots develop throughout the bloodstream, blocking small blood vessels. The increased clotting depletes the platelets and clotting factors needed to control bleeding, causing excessive bleeding

Question 22

What is acute respiratory distress syndrome

Answer 22

Acute respiratory distress syndrome (ARDS) is a life-threatening condition where the lungs cannot provide the body’s vital organs with enough oxygen. It’s usually a complication of a serious existing health condition.

Question 23

What is the treatment for acute pancreatitis

Answer 23

Symptomatic relief
IV fluids
Analgesia
Treat the underlying cause

Question 24

In a FBC what could be raised in a patient with acute pancreatitis

Answer 24

Serum amylase
Serum lipase
Bilirubin

Question 25

What percentage of acute pancreatitis is mild

Answer 25

70%

Question 26

What percentage of acute pancreatitis is severe

Answer 26

30%

Question 27

What are the two categories of acute pancreatitis

Answer 27

Mild

Severe