CHRNC PNCRTTS

Question 1

Most common symptom of Chronic pancreatitis

Answer 1

Abdominal pain

Question 2

Mechanism of abdominal pain in chronic pancreatitis (3)

Answer 2

DIN

Ductal hypertension
Inflammation of Parenchyma
Neural Involvement

Question 3

Strategies to relieve abdominal pain in Chronic Pancreatitis

Answer 3

Reduce secretion and/or decompress the secretory compartment
Resecting focus of chronic inflammatory change
Neural ablative procedures

Question 4

True about malabsorption and weight loss in pancreatitis

a. occur when exoctine capacity <10%
b. Associated with Diarrhea and Steatorrhea
c. Stool is described as oil slick
d. if severe steatorrhea, green oily stool is often reported.
e. lipase deficiency tends to manifest itself before trypsin deficiency

Answer 4

D

Question 5

A chronic collection of pancreatic fluid surrounded by a nonepithelialized wall of granulation tissue and fibrosis

Answer 5

pseudocyst

Question 6

What percentage of patients with acute pancreatitis develop a pseudocyst?

Answer 6

10%

Question 7

Acute pseudocyst

a. <7 weeks
b. <6 weeks
c. <5 weeks
d. <4 weeks

Answer 7

B

Question 8

Acute pseudocyst resolve spontaneously in up to 50% of cases over a course of __ weeks or longer

Answer 8

6 weeks

Question 9

cut off of pseudocyst size that will resolve less frequently, more likely to be symptomatic

Answer 9

> 6cm

Question 10

what do you call bleeding from the pancreatic duct into the gastrointestinal tract via the ampulla of Vater

Answer 10

Hemosuccus pancreaticus

Question 11

Symptoms of pseudocysts

Answer 11

PEF
pain
fullness
early satiety

Question 12

Imaging of choice for pseudocyst

Answer 12

Contrast Enhanced Imaging of choice

Question 13

A collection of enzyme-rich pancreatic
juice that occurs early in the course of
acute pancreatitis, or that forms after a
pancreatic duct leak; located in or near
the pancreas; it lacks a well-organized
wall of granulation or fibrous tissue

Answer 13

Peripancreatic fluid collection

Question 14

A focal or diffuse area of nonviable
pancreatic parenchyma, typically
occupying >30% of the gland and
containing liquefied debris and fluid

Answer 14

Early pancreatic

(sterile) necrosis

Question 15

An organized collection of sterile
necrotic debris and fluid with a welldefined
margin or wall within the
normal domain of the pancreas

Answer 15

Late pancreatic

(sterile) necrosis

Question 16

A collection of pancreatic juice enclosed
within a perimeter of early granulation
tissue, usually as a consequence of acute
pancreatitis that has occurred within the
preceding 3–4 wk

Answer 16

Acute pseudocyst

Question 17

Chronic pseudocyst

Answer 17

A collection of pancreatic fluid
surrounded by a wall of normal
granulation and fibrous tissue, usually
persisting for >6 wk

Question 18

treatment of pseudocyst if lying posterior to stomach

Answer 18

cystogastrotomy

Question 19

tx of pseudocyst Ideal for internal drainage
If located at body and tail
Not adhere to stomach , Bulging through T.colon

Answer 19

Cystojejunostomy

Question 20

tx of pseudocyst if located at head of pancreas

Answer 20

Cystoduodenostomy

Question 21

most common site of pancreaticoenteric fistula

Answer 21

Transverse colon, splenic flexure

Question 22

Management of pancreatico fistula to stomach/duodenum

Answer 22

no management, will resolve spontaneously, leave fistula

Question 23

Low output fistula

a. <300 mL/day
b. <400 mL/day
c. <500 mL/day
d. < 1L/day
e. NOTA

Answer 23

E. <200 mL/day

Question 24

High output fistula

a. > 200 mL/day
b. > 300 mL/day
c. > 400 mL/day
d. > 500 mL/day

Answer 24

A