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Y1 GI > Inflammation and tumours of the pancreas > Flashcards

Inflammation and tumours of the pancreas Flashcards

1
Q

What arteries supply the pancreas

A

Gatroduodenal gives off a branch - anterior and posterior superior pancreatiduodenal

Superior mesenteric gives off pancreatlduodenal

branches off splenic

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2
Q

What is the accessory pancreatic duct

A

Extra duct other than the pancreatic that joins the pancreas to the duodenum in a slightly different place

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3
Q

endocrine function

A

secretion of insulin and glucagon

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4
Q

Exocrine function

A

secretion of digestive enzymes

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5
Q

Pancreatic fluid regulation

A

secretions regulated by vagus nerve and gastrin levels

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6
Q

What do acing cells secrete

A

protease
Pancreatic lipase
Pancreatic amylase
Other enzyme

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7
Q

What how are 80% of acute pancreatitis treated

A

analgesia and IV fluids

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8
Q

I GET SMASHED

A

I-idiopathic

G-gallstones
E- ethanol
T-trauma

S-steriods 
M-mumps and malignancy 
A- autoimmune conditions 
S- scorpion bite 
H- hypercalceamia and hypolipidemia 
E-ERCP -causes 3% of cases 
D-Drugs
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9
Q

Pancreatic due to autoddigestion of pancreas

A

Pancreatic enzymes are released and activated

these auto digest pancreas

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10
Q

Four stages of auto digestion pancreatitis

A

Hypovolaemic shock -oedema and fluid shits
Autodigestion of blood vessels - retroperitoneal haemorrhage
Infarction due to compromised blood supply - pancreatic neucrosis
MORE

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11
Q

Clinical presentation of pancreatitis

A 
Acute onset of epigastric pain 
Radiating through to back 
Very severe 
Double over 
Nausea and vomiting 
Jaundice

Trigger identified- gallstones, ERCP

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12
Q

Examination findings for pancreatitis

A

Upper abdominal tenderness
Soft
Normal bowel sounds
Fullness in epigastrium

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13
Q

Classical signs of pancreatitis

A 
Erythema abinge (hot water bottle rash) 
Grey turners sign (flanks) 
Cullens sign (umbilical)
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14
Q

Initial investigations for pancreatitis

A 
IV access 
Bloods 
-FBC & coagulation 
-Us&Es, LFTs, calcium, glucose, amylase/lipase, CRP & lactate 
ABGs 
-hypoxia 
-acute respiratory distress syndrome

Xray
Ultrasouns
CT- to look for severity/complications

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15
Q

Why do patients with pancreatitis get pleural effusions

A

They fail to inflate their lungs properly cause of pain

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16
Q

What signs are seen on CXR in pancreatitis

A

Sentinel loop -small bowel lying over pancreas

Pleural effusion

17
Q

What to look for on US

A

Gallstones
CBD size - norm = 4-5mm (60-6,70-7,80-8)
Cholysytitis
Free fluid

18
Q

Complications of pancreatitis

A 
Fluid collection 
Pancreatic/peripancreatic necrosis 
Ascites 
Bleeding 
Abscess
19
Q

Gallstone pancreatitis is worse than ERCP pancreatitis which is worse than alcoholic pancreatitis true/false

A

False

ERCP worse than gallstone and alcoholic

20
Q

When is ECRP used

A

when cholecystectomy not possible

To get rid of gallstones

21
Q

Glasgow criteria prognostic

A 
P- PaO2 <8kPa 
A- age >55 
N- neutrophils 
C-calcium 
R-renal function 
E-enzymes
A-albumin 
S-sugar (glucose) 
>3 = serve pancreatitis
22
Q

Management for pancreatitis

A 
Conservative 
Fluid resuscitation 
Correct electrolytes 
Careful fluid balance 
Oxygen 
Antibiotics
Nutrition

Indec admission laparoscopic cholecystectomy

23
Q

What are pancreatic pseudocyst

A

occur because of communication with the pancreatic duct

cause biliary obstruction, gastric outlet obstruction

24
Q

How to diagnose pancreatic pseudocysts and treatment

A

Pain, nausea, vomiting, jaundice, weight loss

treatment 
nothing 
endoscopic drainage 
radiological drainage 
surgical drainage
25
Q

Where do pancreatic pseudocysts get drained into

A

the stomach

26
Q

How is pancreatic necrosis managed

A

CT for assessment

Drain or necrosectomy and lavage

27
Q

What is chronic pancreatitis

A

Progressive and irreversible change

Close of exocrine and endocrine function

28
Q

Presentation of chronic pancreatitis

A

Similar to acute
Alcoholism, smoker, medications
Masses, ascites, jaundice

29
Q

Imaging for chronic pancreatitis

A 
CXR/AXR 
USS 
CT pancreas 
MRI 
ERCP
30
Q

Aetiology for chronic pancreatis

A 
Alcohol 
idiopathic 
PD obstruction 
genetic predisposition 
Autoimmune disease
31
Q

CT findings in chronic pancreatitis

A

Calcification

PD dilation

32
Q

Management of chronic pancreatitis

A

Surgery

Creon - enzyme replacement therapy

33
Q

Pancreatitis complications

A 
Splenic vein thrombosis 
pseudo aneurysm -splenic artery
pleural effusion 
ascites 
pancreatic cancer 
pseudocyst 
biliary obstruction
34
Q

Most common kind of pancreatic carcinoma

A

Insulinoma

35
Q

Pancreatic cancer symptoms

A

painless jaundice
weight loss
back pain

36
Q

Risk factors for pancreatic cancer

A

smoking
obesity
diabetes
charred meat

Y1 GI (41 decks)

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