Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Gastrointestinal (LECTURE NOTES) > Pancreaatobiliary emergencies: acute pancreatitis > Flashcards

Pancreaatobiliary emergencies: acute pancreatitis Flashcards

1
Q

What is the diagnosis of acute pancreatitis based on

A

The characteristic abdominal pain and nausea combined with elevated serum levels of pancreatic enzymes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What must be given immediately in acute pancreatitis

A

Fluid resuscitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What has caused an increase in emergencies recently

A

The increase in alcohol consumption

The better diagnostic capability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the mortality rate in patients with acute pancreatitis

A

5%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does the pathological process involve in acute pancreatitis

A

Inflammation
oedema
necrosis of pancreatic tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the mneumonic for the causes of acute pancreatitis

A 
Gall stones
Ethanol
Trauma
Steroids
Mumps
Autoimmune
Spider bites/ scorpion bites
Hypertriglyceridaemia, hypercalcaecmia
ERCP
Drugs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What might cause premature activation of pancreatic enzymes

A

Obstruction by protein plugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is pancreas divisum

A

Where there is failure of the dorsal and ventral ducts to fuse in the embryo so that most of the pancreatic juice flows through the minor pancreatic duct and papilla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What happens when the pancreas becomes inflamed

A

Activation of pancreatic enzymes within the gland itself

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What do the pancreatic enzymes do

A

Damage tissue

activating complement and the inflammatory cascade and produce cytokines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What 3 things can occur as a result of a systemic inflammatory response

A

Respiratory distress syndrome
Cardiovascular failure
renal failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the main result of acute pancreatitis

A

A chemical burn - activated enzymes and cytokines enter the peritoneal cavity resulting in capillary leakage of pancreatic fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are pseudocysts

A

Collections of pancreatic fluid and tissue debris formed around the pancreas surrounded by a fibrous lined capsule (not epithelial)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are 3 metabolic complications of pancreatitis

A

Hypocalcaemia
Hypomagnesaemia
hyperglycaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What might become infected in pancreatitis

A

The pancreatic pseudocysts of the necrotic tissue by enteric bacteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

In what region is pancreatic pain found

A

Epigastric

17
Q

Where does pancreatic pain radiate to

A

The back (50% of patients)

18
Q

What might reduce the pain

A

Sitting up and leaning forwar

19
Q

What might accentuate the pain

A

Coughing
Vigorous movement
Deep breathing

20
Q

What are 2 other common presentations

A

Nausea and vomiting

21
Q

What might be heard on a respiratory examination of a patient with pancreatitis

A

Basal crackles consistent with atalectasis

22
Q

What is Grey- Turner’s sign

A

Blue-grey discolouration of the flanks due to exudation of fluid sustained by pancreatic necrosis into the subcutaneous tissue

23
Q

What is the Cullen’s sign

A

Discolouration in the periumbilical area

24
Q

What might the bowel sounds be liek in pancreatitis

A

Hypoactive

25
Q

What might reduce the pain

A

Sitting up and leaning forward

26
Q

What might the bowel sounds be like in pancreatitis

A

Hypoactive

27
Q

How is the severity of acute pancreatitis defined

A

The presence or absence of organ failure, local complications or both

28
Q

What is the scoring system used in pancreatitis

A

Ranson criteria

29
Q

When is the Ranson criteria completed

A

48 h after onset of the episode

30
Q

What are some clinical findings that indicate severe disease

A 
Thirst
poor urine output 
pregressive tachycardia 
tachypnoea 
hypoxaemia
agitation
confusion
rising haematocrit level 
lack of improvement in symptoms
31
Q

What is the most widely available test for pancreatitis

A

Serum amylase

Lipase

32
Q

What should all patients have following a thorough history and physical examination

A 
Serum amylase (and lipase if available)
FBC
U&E
Coagulation screening
LFT
Serum alctate
Calcium, magnesium
Glucose 
ABG
Biliary ultrasonography
33
Q

What are some of the follow up investigations

A

Fasting plasma lipids and calcium

repeat biliary ultrasonography

34
Q

What must be excluded from the differential diagnosis in recurrent idiopathic acute pancreatitis

A

Pancreatic cancer
microlithiasis
chronic pancreatitis
pancreas divisum

35
Q

What analgesia should be given

A

Opiate

36
Q

What opiate should be avoided and why

A

Morphine - it might exacerbate pancreatitis by increasing sphincter of Oddi tone

37
Q

What nutritional support should be the goal for all patients with acute pancreatitis

A

Enteral

Gastrointestinal (LECTURE NOTES) (29 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions