Day 6- Pancreatitis Flashcards
What are the 3 big enzymes needed for digestion the pancreas releases?
What is the big defining characteristic of acute pancreatitis?
What does IGETSMASHED stand for?
Amylolytic, Lipolytic, Proteolytic.
Abdominal pain(very severe). Rarely progresses to chronic pancreatitis.
Idiopathic, Gallstones(#1 cause), Ethanol(#2 cause, 50g/day over 5 years), Trauma, Scorpion sting/ snake bite, Mumps, Autoimmune disorder, Steroids, Hyper triglyceridemia, calcemia, glycemia, ERCP, DRUGS.
What is class 1,2, and 3 drug induced pancreatitis?
What are your markers of acute pancreatic injury?
What are your diagnostic tests for pancreatic injury?
Class 1: definite association(at least 20 case reports with 1 positive rechallenge). Class 2: probable(10-19), Class 3: (<10).
Lipase, Amylase(does not rise in ethanol and triglyceride).
CT scan- confirms presence and severity, Ultrasound- gall stones, ERCP- remove gallstones.
What are your basics for fluid resuscitation in pancreatitis?
What else do you give to treat pancreatitis?
Who needs antibiotics in pancreatitis?
Fluid resuscitation(250-500 mL/hr). Lactated ringers or normal saline but LR preferred.
Oxygen supplementation, NPO until N/V and ab pain resolves. Pain Management( IV morphine and hydropmorphone are 1st line, IV fentanyl is also appropriate).
Proven/confirmed infected(fine needle aspirate), Suspected infection of the pancreas, other types of infection.
What antibiotics do you need to give generally in pancreatitis?
Who gets anti secretory treatment?
What is Chronic Pancreatitis characterized by?
IV carbapenem. If beta lactam allergic use IV fluoroquinolone and IV metronidazole.
SEVERE.
Ab pain–> Steatorrhea–> diabetes. Pancreas burns out.
What causes chronic pancreatitis?
What is in PEP’s?
What are the pros and cons of microencapsulated preparations?
Alcohol(#1), Idiopathic, other causes.
Lipase, Protease, Amylase.
Pro: Avoid degradation. Con: PPI or H2RA.
What are the pros and cons of conventional immediate release form?
Should you use probiotics in pancreatitis?
Do you need to give PEP’s with every meal and snack?
Pro: PPI or H2RA. Cons; Runs risk of breakdown.
NOOOOO!
YES
