chronic pancreatitis Flashcards

1
Q

what is it

A

persistent chronic inflammation often due to repeated bouts of acute pancreatitis or insidiously developing

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2
Q

pathology

A

healthy tissue replaced by misshapen ducts fibrosis and Ca deposits due to chronic inflammation

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3
Q

outline the effect alcohol has on th pancreas

A

impairs calcium regulation leading to inc levels - Ca deposit

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4
Q

what may inflammation and fibrosis mimic in the head of the pancreas

A

cancer

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5
Q

how does smoking affect the disease

A

inc the advancement

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6
Q

what happens to acinar and islet cells

A

destruction

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7
Q

consequences of destruction acinar cells

A

produce fewer digestive enzymes - pancreatic insufficiency

cant absorb fat as well - weight loss and deficiency in ADEK (fat soluble vitamins)

fat may pass undigested - steatorrhoea

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8
Q

causes

A

alcohol

hereditary - alpha 1 antitrypsin deficiency and CF

gallstones

tropical countries - areas deficient in methionine, zinc and selenium

hyperparathyroidism

malnourishment

familial

pancreatic duct obstruction

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9
Q

what is the main cause of chronic pancreatitis in kids

A

CF

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10
Q

how does hyperPTH cause chronic pancreatitis

A

inc levels of blood Ca

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11
Q

O/E

A

tenderness, peritoneum, mass, ascite, jaundice abdominal pain in epigastric region which may radiate to back

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12
Q

imaging - CT

A

show calcification, dilated pancreatic duct, intrapancreatic fluid collection

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13
Q

imaging - XR

A

show calcification

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14
Q

imaging - ERCP

A

can imagine ducts and see structural changes

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15
Q

complications

A

develop diabetes mellitus - islet cells

pseudocyst - lead to pseudo aneurysms

pancreatic cancer

bile duct obstruction

ascites and pleural effusion

splenic vein thrombosis

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16
Q

treatment

A

stop risk factor -alcohol, reduce fat

endocrine function - address diabetes

exocrine function - supplements e.g. CREON

pain - opioids and NSAIDs

17
Q

surgery

A

join jejunum/duodenum to pancreas so pancreatic juice can drain

18
Q

surgical procedures

A

pustow frey beger

19
Q

what is the best test for pancreatic function

A

faecal elastase

20
Q

what is a pseudocyst

A

fluid collection surround by granulation tissue

21
Q

how can the aetiology of pleural effusion be determined

A

high ascites or pleural fluid amylase