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MS4 ADRN.210 - rotation 2 > Ch. 44 - Biliary Disorders - week 2 -pancreatitis > Flashcards

Ch. 44 - Biliary Disorders - week 2 -pancreatitis Flashcards

MS4 - rotation 2

1
Q

Amylase is a pancreatic enzyme that aids in the digestion of_______.

A

carbohydrates

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2
Q

Cholecystectomy is the removal of the ___________.

A

Gallbladder

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3
Q

Acute or chronic inflammation of the gallbladder is____________.

A

Cholecystitis

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4
Q

Which hormone stimulates the release of digestive enzymes and stimulate contraction in the gallbladder?

A

CCK - cholecystokinin

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5
Q

What is the procedure of making a surgical opening for the gallbladder to drain?

A

cholecystostomy

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6
Q

Cholelithiasis is caliculi in the gallbladder, what is it called when there are stones in the common bile duct?

A

choledocholithiasis

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7
Q

What is a choledochostomy?

A

this is a opening in the common bile duct

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8
Q

If there is expected pancreatitis, what 2 labs will you look at?

A

Amylase and Lipase

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9
Q

Dissolution therapy is when you use medication to ________ gallstones.

A

dissolve

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10
Q

Lipase is a pancreatic enzyme that helps digest _______.

A

fat

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11
Q

Lithotripsy is the disintegration of gallstones via ___________.

A

shock waves

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12
Q

Acute or chronic inflammation of the pancreas is __________.

A

pancreatitis

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13
Q

What does the hormone secretin stimulate the release of in the pancreas?

A

Bicarbonate

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14
Q

what is the frothy, foul smelling, greasy stool associated with pancreatitis?

A

steatorrhea

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15
Q

what is causing steatorrhea in a patient with pancreatitis?

A

impaired fat + protein digestion and lack of pancreatic juices

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16
Q

Trypsin is a pancreatic enzyme that digests _______.

A

protein

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17
Q

What is Zollinger - Ellison Syndrome?

A

this is when tumors caused by pancreatic cells cause the stomach to hyper-secrete gastric acid, which causes ulcers

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18
Q

what is the difference between interstitial edematous pancreatitis and necrotizing pancreatitis?

A

interstitial edematous pancreatitis involves only inflammation and swelling of the pancreatic tissue without cell death (necrosis), while necrotizing pancreatitis is a more severe form where actual pancreatic tissue dies due to necrosis

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19
Q

pancreatitis is the self/ autodigestion of the pancreas by its own _______. They are released too early which causes the ___________.

A

-Enzymes
-Inflammation

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20
Q

what are some less common causes of pancreatitis? (4)

A

-infection (mumps)
-ABD trauma or surgery
-meds. - steroids or NSAIDs
-cystic fibrosis

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21
Q

What does alcohol do to cause pancreatitis?

A

-stimulate production of digestive enzymes
-increase sensitivity of cholecystokinin
-which, stimulates pancreatic enzyme production, and causes the autodigestion

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22
Q

Where will a patient with acute pancreatitis have pain? (3)

A

-LUQ
-midepigastrum
-radiates to the back

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23
Q

How would a patient describe their pain, who is experiencing acute pancreatitis? (4)

A

-sudden onset
-severe/ deep
-aggravated by eating
-vomiting does not relieve it

24
Q

Which sign of Acute Pancreatitis is bluish discoloration of the flanks?

A

grey-turner’s sign

25
Q

Which sign of acute pancreatitis is the bluish discoloration around the umbilicus?

A

Cullen’s sign

26
Q

What are the 2 classic symptoms of chronic pancreatitis?

A

jaundice and weight loss

27
Q

What are the 3 most common causes of acute pancreatitis?

A

-biliary tract disease
-gallbladder disease
-alcoholism

28
Q

What should you teach your patient about diet, related to their pancreatitis if they’re not NPO? (4)

A

-small, frequent meals
-bland, easy to digest foods
-low fat/ high protein/ high carb.
-NO ALCOHOL

29
Q

Clinical Manifestations of Pancreatitis:

Frank Caught Dinner Every Night while drinking Beer

** Leslie Loves Happy-hour, Tequila, Jack + Apple martinis**

A

F-flushing
C-cyanosis
D-dyspnea
E-edema
N-n/v
B-bowel sounds = decreased/absent

L- low grade fever
L- leukocytosis (high WBCs)
H-hypotension
T- tachycardia
J- jaundice
A- ABD tenderness/pain

30
Q

The 2 significant complications of pancreatitis include __________ (outside pancreas)+ _________(inside pancreas). This occurs because pancreatic fluid leaks out of the damaged pancreatic duct.

A

-pseudocysts occur outside the pancreas
-abscesses occur inside the pancreas

31
Q

If a patient with pancreatitis develops a fever, a palpable epigastric mass that is filled with liquid, necrotic secretions, N/V, ELEVATED AMYLASE, what complication are they probably experiencing?

A

a pseudocyst

32
Q

How is a pseudocyst treated? and what happens if it perforates?

A

-it will be internally drained

-peritonitis

33
Q

An abscess is a fluid filled cavity within the pancreas as a result of necrosis. What will you observe in your patient experiencing this? (4)

these have to be SURGICALLY drained

A

-upper ABD pain
-ABD mass
-high fever
-leukocytosis

34
Q

What are 3 complications to your respiratory system, secondary to pancreatitis?

A

-pleural effusion
-atelectasis
-pneumonia

35
Q

Acute pancreatitis will cause tetany due to hypocalcemia. What 2 signs will you see in your patient?

A

-Trousseau’s sign (spasm W/ bp cuff)

-Chvostek’s sign (twitch when facial nerve is tapped)

36
Q

True or False?
pancreatic enzymes will be elevated especially AMYLASE

A

true

37
Q

on a CBC, WBCs, liver enzymes, bilirubin and glucose will all be ________.

A

elevated

38
Q

on a CBC, platelets, calcium and magnesium will all be ____________.

A

decreased

39
Q

what are the 5 objectives when treating a patient for Acute Pancreatitis?

A

-relieve pain
-prevent/ treat shock
-decrease pancreatic secretions
-fluid/ electrolyte balance
-remove/ treat cause

40
Q

What are the 2 orders a dr. will put in for the suppression of pancreatic enzymes?

A

-NPO diet order
-NGT suction order

41
Q

What is it called when you have excessive amounts of fat in your stool, and how does pancreatitis cause this?

A

-steatorrhea

  • the pancreatic enzymes aren’t doing their job and breaking down fat
42
Q

in chronic pancreatitis what replaces pancreatic tissue after it’s destroyed from the constant inflammation? and what can it also lead to? (2)

A

fibrotic tissue - this is hardened tissue due to the constant inflammation

-strictures
-calcifications

this tissue leads to stiffening + loss od function of that organ

43
Q

What are the 2 types of CHRONIC pancreatitis?

A
  1. calcifying
  2. obstructive
44
Q

what is obstructive pancreatitis most commonly associated with?? (the cause)

A

biliary disease, cholelithiasis

45
Q

Where in the pancreas does calcification occur?

A

in the head and around the pancreatic duct

46
Q

Chronic calcifying pancreatitis is the most common form, and it may also be referred to as what?

A

alcohol induced pancreatitis

47
Q

What are the clinical manifestations of chronic pancreatitis? (7)

A

-ABD pain + tenderness
-weight loss
-constipation
-jaundice w/ dark urine
-steatorrhea
-frothy urine + stools
-diabetes

48
Q

Some complications of chronic pancreatitis include:

Polly Anne Anderson Picked Strawberries, Plums + Papaya

A

P- pseudocyst
A - ascites
A - abscesses
P - pleural effusion
S - splenic vein thrombosis
P -pseudoaneurysms
P -pancreatic cancer

49
Q

What will a patients labs look like if they have chronic pancreatitis?

A

-amylase/lipase may be slightly increased or not at all

-phosphate is increased

-mild leukocytosis

50
Q

What is an ERCP and what does it do?

A

Endoscopic Retrograde Cholangiopancreatography

this will visualize the common bile duct and the pancreatic duct

51
Q

What other diagnostic tests are used for pancreatitis? (3)

A

-ultrasounds
-CT
-MRI

52
Q

what is an MRCP? and what is it used for?

A

Magnetic resonance cholangiopancreatography

this is an MRI specific to the pancreatic and biliary systems

53
Q

What 2 things do Bile Salts do?

A

-help absorb fat soluble vitamins, which helps to prevent further fat loss

54
Q

What 2 enzymes are used for pancreatic enzyme replacement?

A

pancreaze and viokace

55
Q

If surgery is needed, what 2 things is it going to do?

A

divert bile flow or relieve the obstruction

56
Q
A

MS4 ADRN.210 - rotation 2 (7 decks)

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