pancreas Flashcards
Ranson score timing?
initial and at 48h
initial factos for ranson?
age, WBC, BG, LDH, AST
48 hr ranson factors?
hct fall, BUN inc, hypocalcemia, hypoxemia, high base deficit, large fluid sequestration
iniital pathophys of pancreatitis?
injury causes cleavage of proteolytic enzymes causing autodigestion and necrosis with eventual release of cytokines causing SIRS response
when to start TPN with pancreatitis?
if you cant feed within 7 days
gold standard diagnosis of pancreatitis?
CT with contrast
when to give abx in pancreatitis?
not recommended unless definitive necrosis more than 30%
when to drain collection?
luminal gas, high infection concern
thrombotic complication of pancreatitis?
splenic vein thrombosis, portal vein, SMV
management of pancreatic necrosis?
repeat scans to look for gas, goal is to wait for organization before definitive treatment
treatment of hypertriglyceridemia induced pancreatitis?
IV insulin, subq heparin, pharesis if no resolution
goal serum markers in triglyceride induced pancreatitis?
triglycerides <500, normal glucose
tx for infected pancreatic pseudocyst? 2nd line?
perc drainage/endoscopic necrosectomy
complications of pseudocyst?
obstruction, rupture leading to left effusion, infection
pseudocyst causing large pleural effusion treatment?
cystogastrostomy or cystojejunostomy
