OnlineMedEd: Gastroenterology - "Pancreatitis"

Question 1

What are the signs and symptoms of pancreatitis?

Answer 1

• Epigastric pain that radiates to the back
• Pain that worsens when lying back and improves with leaning forward
• N/V
• Anorexia

Question 2

The best test for pancreatitis is ______________.

Answer 2

lipase (amylase can be elevated by vomiting)

Question 3

Review the treatment of pancreatitis.

Answer 3

• IVF
• Morphine (or some kind of analgesia)
• NPO with advancing diet

Question 4

List the causes of pancreatitis.

Answer 4

• Gallstones
• Alcohol
• Medications (e.g., antiretrovirals, GLP-1 agonists, valproate)
• Trauma (the ERCP procedure usually causes a mild pancreatitis)

Question 5

Explain Cullen and Turner sign.

Answer 5

• Cullen: umbilical hematoma (cULLen = UmbiLicaL)

* Turner: retroperitoneal hematoma (you TURN out your flank where TURNER’s sign is)

Question 6

Ultrasounds and MRCPs are not good at diagnosing pancreatitis, but ________________.

Answer 6

they can reveal the etiology (like gallstones or strictures in the pancreatic duct)

Question 7

While the ___________ criteria are the best at determining the prognosis of pancreatitis, the single best test is ____________.

Answer 7

Ranson’s; BUN

Question 8

Review the early, intermediate, and late complications of pancreatitis.

Answer 8

• Early:

• ARDS
• Hypocalcemia
• Pleural effusion
• Ascites

• Mid:
- Infection

•Late:

• Pseudocyst
• Abscess

Question 9

How are post-pancreatitis infections treated?

Answer 9

• Meropenem until the culture narrows treatment

* Biopsy

Question 10

Describe the rule of 6s (regarding pseudocyst management).

Answer 10

• If the cyst is less than 6 cm and younger than 6 weeks old, watch and wait.
• If the cyst is greater than 6 cm or older than 6 weeks, drain and biopsy.