Gastro

Question 1

2 main causes of Pancreatitis

Answer 1

Gallstones (less developed country)

Alcohol (more developed country)

Question 2

Pain characteristics in pancreatitis?

Answer 2

Severe
LEQ/epigastric
Radiates to back
Decreases over 72h

Question 3

Vomiting with LUQ pain, sudden onset?

Answer 3

Pancreatitis

Question 4

Signs of pancreatitis?

Answer 4

Jaundice
Abdo tenderness with rigidity
Cullens and Grey turners signs
Hyperlipidaemia signs (e.g. xanthelasma)

Question 5

Cullen’s sign?

Answer 5

Colouration of skin around umbilicus - acute abdomen

Question 6

Grey Turners sign?

Answer 6

Flank colouration - acute abdomen

Question 7

Sensitive and specific test for acute pancreatitis

Answer 7

serum lipase

Serum amylase is traditionally used but is not as good

Question 8

Bloods for acute pancreatitis

Answer 8

FBC, U+E, Glucose, CRP (useful in determining prognosis)
LFT’s
Calcium (common to by hypocalcaemic)

Question 9

Name a scoring system used for acute pancreatitis

Answer 9

APACHE II

Glasgow score

Question 10

Pain relief used for acute pancreatitis

Answer 10

NOT MORPHINE
This constricts sphincter of Oddi

Instead, give pethidine or bubrenorphine with or without IV benzo’s

Question 11

Management of acute pancreatitis

Answer 11

IV fluids and NBM
NG if severe vomiting
Treat cause
Abx to cover specific infections
Send to ITU if severe