Others

Question 1

Causes of pancreatitis?

Answer 1

idiopathic, gallstones, ethanol, trauma, steroids, mumps/HIV/Coxsackie infection, autoimmune, scorpion, hyperlipidaemia/hypercalcaemia/hypothermia, ERCP, drugs (sodium valproate, thiazides, azathioprine).

Question 2

Glasgow scale for severity and prognosis of pancreatitis?

Answer 2

Pao2 - <8 kPa Age >55yrs Neutrophila >15 x 109cells/L Calcium <2.0mM Renal function; urea >16 mM Enzymes; LDH >600U/L Albumin <32 g/L Sugar >10mM A score of 3 or more is severe requiring intensive management in ITU.

Question 3

Pancreatitis supportive care?

Answer 3

IV fluids, O2, analgesia, antiemitics, DVT prophylaxis, low fat diet if tolerated.

Question 4

Pancreatitis surgical care?

Answer 4

Laparoscopic cholecystectomy; done within 2 weeks if gallstones identified by USS.

Question 5

Complications of peptic ulcers?

Answer 5

Haemorrhage – high morbidity and more severe on anticoagulants, symptoms include haematemesis and malanea. Perforation – patients taking NSAIDs most at risk, usually leads to peritonitis. Penetration – may occur into the pancreas, omentum, biliary tract, colon and vsculature. Scarring – if severe can lead to gastric outlet obstruction. Malignancy – risk factor from adenocarcinoma of stomach.

Question 6

Complications of pancreatitis local?

Answer 6

necrosis of the pancreas, abscess formation, pseudocysts.

Question 7

Complications of pancreatitis systemic?

Answer 7

sepsis, shock, acute renal failure, resp compromise, disseminated intravascular coagulation (DIC).