Lesson 3.1 - Panc Path (part 1) Flashcards
GDA vs CBD location - which is more anterior
GDA more anterior
when might serum amylase increase? (4)
- pancreatitis
- obstruction intestinal
- pseudocyst
- peptic ulcer disease
when does serum amylase decrease (2)
hepatitis
cirrhosis
in episodes of acute pancreatitis, which stays increased longer urine or serum amylase?
urine amylase
what stays elevated the longest?
serum lipase
elevated serum lipase assoc with (6)
- pancreatitis
- obstruction panc duct
- carcinoma
- cirrhosis
- acute cholecystitis
- severe renal disease
what cases indicate elevated glucose
- diabetes mellitus
- chronic liver disease
- over activity of endocrine glands
glucose decreases with
tumours of islets of langerhands in the pancreas
t/f increased echogenicity in the pac is not always a result of fatty replacement
true
panc normal variant size (1)
pseudomass - larger head bulging to right of GDA
what area of the pancreas (and size) may indicate acute pancreatitis
if the body exceeds 3 cm AP
what size should the panc duct measure
3 mm or less
congenital anomalies (3)
- pancreatic divisum
- annular pancreas
- partial agenesis
what is the most common pancreas variant
pancreatic divisum
describe annular panc
duodenum encircled by a ring of pancreatic tissue - may constrict duo
when do we use doppler (3)
- any mass
- suspected pancreatitis
- if splenic vein does not appear anechoic and is over distended
are pancreatic enzymes increased or decreased with acute pancreatitis
raised
what are the causes/risk factors of acute pancreatitis?
gallstones (40%)
alcoholism (40%)
what should you do if you suspect acute pancreatitis? (3)
evaluate the biliary tree for gallstones, choledochlithiasis and obstruction
other causes of acute pancreatitis (9)
choledocholithiasis
- biliary sludge
- neoplasm
- infection
- toxins
- drugs
- genetic
- traumatic
- iatrogenic factors
steps for diagnosing acute pancreatitis
amylase and lipase elevated on blood test*
pt sent for imaging (US/ CECT)
sono findings of pancreatitis
-panc tissue hypoechoic / enlarged
-surrounding/
potential spaces (lesser sac, anterior pararenal spaces, trans mesacolon)
-biliary system (GB stones, choledocalithasis, dilated ducts)
the most common and useful finding to diagnose pancreatitis
pac assoc inflammation:
Hypoechoic or anechoic collections that conform to the retroperitoneal space
Ascites
*local complications of pancreatitis (4)
fluid collection (40%)
pseudocysts (fluid collection >6 wks)
abscess
necrosis
