Exocrine, Biliary and Hepatic Disorders

Question 1

Wernicke-Korsakoff Syndrome
description and complication: Korsakoff’s psychosis

Answer 1

complication of chronic alcohol abuse

inflammation and hemorrhagic degeneration of the brain caused by a thiamine deficiency (caused by ETOH suppression of thiamine absorption and a poor diet)

can lead to Korsakoff’s psychosis: irreversible anemia, loss of ST memory, cannot learn

Question 2

Wernicke-Korsakoff syndrome: treatments

Answer 2

Thiamine should be given before or with glucose BUT admin of IV glucose to pts. with malnutrition can precipitate WK syndrome, BUT ALSO tx for life-threatening hypoglycemia should NOT be withheld for thiamine administration

Question 3

Tx: withdrawl

Answer 3

“bannanna bag”
Daily 1 L of DS 1/2 NS with MVI, folate, thamine, mg2+

Question 4

Pancreatitis description and risk factors

Answer 4

inflammatory process associated with edema, auto-digestion of pancreas, fat necrosis, hemorrhage (trypsin is activated to trypsinogen–> bleeding)

risk factors: alcohol abuse, gallstones, trauma, viral infection, metabolic demands, medications (estrogens and Azathiropine)

Question 5

Acute Pancreatitis: Picmonic

Answer 5

mechanisms: heavy alcohol use and gallstones

sx/sx: abdominal pain
guarding and rigidity
decreased or absent bowel sounds
nausea, vomiting, anoREXia
hypotension
tachycardia
jaundice
increased WCS

Question 6

Acute Pancreatitis

Question 7

Pancreatitis clinical manifestations

Answer 7

Abdominal pain
Epigastric / umbilical
Radiates to back, chest, flank, lower abdomen
12-48 hours after ETOH binge
Aggravated by eating
Nausea, vomiting
Abdominal distention
Fever

Edema of pancreatic capsule
Local peritonitis
Ductal spasm
Auto-digestion
Increased enzyme production with eating

Question 8

pancreatitis complications

Answer 8

hypotension, hypovolemia,
pallor
decreased level of consciousness
shock

Question 9

pancreatitis labs

Answer 9

serum/urine amylase and serum lipase are most sensitive indicators
serum Ca2+ and glucose, bilirubin, alkaline phosphatase, BUN, liver function tests, MRI, CT scan, chest X-ray, abdominal X-ray

Question 10

pancreatitis goals

Answer 10

relieve pain
prevent shock
decrease pancreatic secretions
correction of fluid and electrolyte imbalance
prevent and treat infections, remove precipitating cause.