Acute Pancreatitis

Question 0

MCC (2) of acute pancreatitis?

Answer 0

Alcohol & gallstones

Question 1

How do you diagnose acute pancreatitis?

Answer 1

Needs 2/3 criteria:

• Abd. pain
• Amylase/lipase >3x normal
• Imaging showing char. findings

Question 2

What is the role of alcohol & cigs in acute pancreatitis?

Answer 2

Alcohol - can only cause AP 5-10 years down the line

Cigs - does not really cause, but accelerates progression

Question 3

Can high triglyceride levels cause acute pancreatitis?

Answer 3

Yes, but only when levels are >1000mg/dL

Question 4

Which procedure carries big risk for development of acute pancreatitis?

Answer 4

ECRP

Question 5

Common bugs causing acute pancreatitis?

Answer 5

Virus: CMV, EBV, HIV
Bact: Salmonella, Mycoplasma
Para: Toxo

Question 6

Differential for causes of acute pancreatitis?

Answer 6

Gallstones, Alcohol, Trauma, ERCP, hyperlipidemia

GATE

Question 7

Abd. pain radiating to the back with ecchymosis on flanks

Diagnosis?

Where else could the ecchymosis show up?

Answer 7

Blood in the abdomen (Grey-Turner sign) from pancreatic necrosis

Could also be around umbilicus (Cullen sign)

Question 8

High amylase levels - ddx?

Answer 8

Intestinal ischemia, renal insufficiency, perf’d peptic ulcer, problems with salivary glands and/or fallopian tubes

Question 9

Apart from acute pancreatitis, what can raise lipase?

Answer 9

Head trauma, heparin, renal insufficiency

Question 10

What is used to classify severity of acute pancreatitis?

Answer 10

C-reactive protein (NOT amylase or lipase)