pancreas Flashcards

1
Q

pathogenesis appendicitis

A

lymphoid hyperplasia or faecolith -> obstruction –> infection –> oedema, ischaemia, perforation

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2
Q

common symptoms appendicitis

A

general abdo pain –> RIF // pain on coughing + speed bumps // mild N+V // temp 37.5-38 // anorexia

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3
Q

o/e appendicitis

A

redbound tenderness // PR = boggy + right sided tenderness // Rosvings = palpate LIF –> pain RIF // psoas = pain extending hip

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4
Q

invx appendicitis

A

raised inflammation // neutrophil raised WCC // thin male = clinical // USS = women

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5
Q

mx appendicitis

A

lap appendicectomy // IV abx

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6
Q

pathophysiology pancreatitis

A

auto digestion pancreas

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7
Q

causes pancreatitis

A

(gallstone or alcohol) // GET SMASHED // Gallstones, Ethanol, Trauma, Steroids, Mumps, Autoiumme, Scorpion, H , ECRP, Drugs

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8
Q

H causes pancreatitis

A

hypertriglyciders // hyperCa // hypothermia

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9
Q

drug causes pancreatitis

A

azathioprine, mesalazine!!, bendroflumethiazide, furosemide, steroids, valproate

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10
Q

features pancreatitis

A

severe epigastric pain –> back // vomiting // low fever

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11
Q

o/e pancreatitis

A

tender // Cullens sign - periumbilical discolouration // grey-turner = flank discolouraition

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12
Q

rare symptom pancreatitis

A

ischaemic retinopathy –> blindness

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13
Q

invx pancreatitis (not imaging)

A

amylase >3x limit // lipase // diagnosis if symptoms + raised lipase or amylase >3x limit

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14
Q

imaging pancreatitis

A

USS

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15
Q

scoring systems pancreatitis

A

ranson, glasgow, apache II

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16
Q

signs severe pancreatitis

A

> 55 // hypoCa // hyperglycaemic // hypoxic // neutrophilic // elevated LDH + AST

17
Q

when is lipase particularly useful pancreatitis

A

late presentation - long half life

18
Q

local complications pancreatitis

A

fluid collection // pseudocysts // necrosis // abscess // haemorrhage

19
Q

peripancreatic fluid collection mx

A

aspirate + drain

20
Q

invx pseudocysts pancreatitis

A

CT, ECRP, MRI

21
Q

mx pseudocysts pancreatitis

A

observe 12 weeks –> aspiration

22
Q

systemic complication pancreatitis

23
Q

mild pancreatitis

A

no organ failure or complications

24
Q

moderate pancreatitis

A

transient organ failure <48hrs + possible local complications

25
severe pancreatitis
organ failure >48hrs + possible complications
26
mx pancreatitis
IV cytsalloids // IV opioids // PO or enteral nutrition // NO abx
27
causes chronic pancreatitis
alcoho!!l // CF, haemochromatosis // duct obstruction
28
features chronic pancreatitis
pain worse just after a meal // steatorrhoea // DM (20 years later)
29
invx chronic pancreatitis
CT // abdo Xray // faecal elastase
30
mx chronic pancreatitis
enzyme supplements // analgesia
31
RF pancreatic cancer
smoking // diabetes // chronic pancreatitis // hereditary NPCC // MEN // BRCA
32
features pancreatic cancer
painless jaundice (pale stool, dark urine, itch) // hepatomegaly, gallbladder mass, epgastric mass // vague symptoms eg anorexia, weigh loss // DM
33
courvoisers law
painless obstructive jaundice + palpable bladder = NOT gallstones
34
invx pancreatic cancer
raised ca199 // CT - double duct // USS
35
mx pancreatic cancer
whipples (pancreaticoduodenectomy) + chemo // palliative = ERCP
36
SE whipples
dumping syndrome + peptic ulcer