pancreas

Question 1

Ducts order

Answer 1

Common bile duct, cystic duct, biliary duct, pancreatic duct

Question 2

Acute pancreatitis def
women-
men-

Answer 2

Injury to pancreatic cells causes activation of the enzymes
W-gallstones M- Chronic alcohol use
BIl disease, trauma, infection, drugs, post op GI, surgery, smoking DM, hypertyglycerides
Mild-Edematous or interstital
Severe-necrotizing, dysfunction, necrosis, organ failure, sepsis

Question 3

Manifestations of acute pancreatitis

Answer 3

Sudden inflam, edema, necrosis, hemorrhage, fat necrosis, vascular perm, smooth mm contractions, shock, ab pain in LUQ, and mid epi that radiates to shoulder and worse with food, N/V that dosent help pain, low fever, Hypotension, Jaundice, gry turners sign, cullens sign (eccymosis), Hyposctive or no bowel sounds, crackles,

Question 4

Complications of acute pancreatitis

Answer 4

plural effusion, atelectasis, pneumonia, ARDS,
Emboli, DIC
Hypotension
hypocalcemia-Tetany
Pseudo cyst- from all the gunk
Ab pain, palpable mass, anorexia, NV, Perf, peritonitis
Abscess- infection of pseudocyst

Question 5

S/S of peritonitis

Answer 5

Increased HR, BP, temp, stiff plap belly,

Question 6

Labs for pancreatitis acute

Answer 6

Panc enzymes, hypoca+,

Liver, triglycerides, glucose, bilirubin,

Question 7

Image for pancreatitis one consideration

Answer 7

Ultrasound, xray for lung changes, contrast, MRCP, ERCP-can make it worse

Question 8

Care for pancreatitis acute

Answer 8

REST the pancreas
Agressive hydration for third spacing, pain management, decrease pan stimulation-NPO NGT, Tx shock, electrolytes, Watch rep for ARDS, watch hypogly, tetany,

Question 9

SURG for pancreatitis acute

Answer 9

ERCP and choleystectomy

Question 10

Drugs for pancreatitis acute

Answer 10

PPI, decrease acid to rest pancreas
Spasmolytics- hypoca
Anticholenergics- DONT DO WITH PER IL

Question 11

Nutrition for acute pancreatitis

Answer 11

NPO initially, Entera-1st( If intestines are not used they get infected)  or parenteral, watch Trigy if IV lipis were given
Small frequent feedings
high carbs-takes less energy
No alcohol 
Fat sol vitamins
Albumin- tx shock
Gluconate and lactated ringers

Question 12

Chronic pancreatitis and about the two types

Answer 12

Irreversible structural damage to the pancreas. This includes fibrotic tissue, strictures, and calcification, Scaring, dilation, stones pass.
Obstructive- Gallstones that cause inflam of sphincter or odi-cancer of amp, duodenum, pancreas, or cystic fibrosis,
Non-obstructive- Inflam and sclerosis in head of pancreases and duct, alcohol abuse

Question 13

manifestations of chronic pancreatitis

Answer 13

Swelling, mass, chronic ab pain, or no pain, mal absorption, weight loss, constipation, DM!, increase in cholesterol, heavy burning not relieves by food or antacids, mild jaundice, dark urine-from bile, Steatorrhea

Question 14

Diagnostic for Chronic pancreatitis labs and image

Answer 14

Panc enzymes, bilirubin, alkaline phosphate, ERCP/MRCP, CT

STOOL-fat

Question 15

Care for chronic vs panc

Answer 15

Increase in WBC, pain-TD, bland low fat diet, no smoking, alcohol, caffeine, panc enzyme replacement, bile salts, insulin or hypo agents, acid inhibiting drugs, antidepressants,

Question 16

Surgery for Pancreatitis chronic

Answer 16

look up

Question 17

Education for chronic pan

Answer 17

diet control, pan enzymes, diabetes education, no alcohol, no smoking, watch for fat in poop, bland diet