pancreas

Question 1

pathogenesis appendicitis

Answer 1

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

Question 2

common symptoms appendicitis

Answer 2

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

Question 3

o/e appendicitis

Answer 3

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

Question 4

invx appendicitis

Answer 4

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

Question 5

mx appendicitis

Answer 5

lap appendicectomy // IV abx

Question 6

pathophysiology pancreatitis

Answer 6

auto digestion pancreas

Question 7

causes pancreatitis

Answer 7

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

Question 8

H causes pancreatitis

Answer 8

hypertriglyciders // hyperCa // hypothermia

Question 9

drug causes pancreatitis

Answer 9

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

Question 10

features pancreatitis

Answer 10

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

Question 11

o/e pancreatitis

Answer 11

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

Question 12

rare symptom pancreatitis

Answer 12

ischaemic retinopathy –> blindness

Question 13

invx pancreatitis (not imaging)

Answer 13

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

Question 14

imaging pancreatitis

Answer 14

USS

Question 15

scoring systems pancreatitis

Answer 15

ranson, glasgow, apache II

Question 16

signs severe pancreatitis

Answer 16

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

Question 17

when is lipase particularly useful pancreatitis

Answer 17

late presentation - long half life

Question 18

local complications pancreatitis

Answer 18

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

Question 19

peripancreatic fluid collection mx

Answer 19

aspirate + drain

Question 20

invx pseudocysts pancreatitis

Answer 20

CT, ECRP, MRI

Question 21

mx pseudocysts pancreatitis

Answer 21

observe 12 weeks –> aspiration

Question 22

systemic complication pancreatitis

Answer 22

ARDS

Question 23

mild pancreatitis

Answer 23

no organ failure or complications

Question 24

moderate pancreatitis

Answer 24

transient organ failure <48hrs + possible local complications

Question 25

severe pancreatitis

Answer 25

organ failure >48hrs + possible complications

Question 26

mx pancreatitis

Answer 26

IV cytsalloids // IV opioids // PO or enteral nutrition // NO abx

Question 27

causes chronic pancreatitis

Answer 27

alcoho!!l // CF, haemochromatosis // duct obstruction

Question 28

features chronic pancreatitis

Answer 28

pain worse just after a meal // steatorrhoea // DM (20 years later)

Question 29

invx chronic pancreatitis

Answer 29

CT // abdo Xray // faecal elastase

Question 30

mx chronic pancreatitis

Answer 30

enzyme supplements // analgesia

Question 31

RF pancreatic cancer

Answer 31

smoking // diabetes // chronic pancreatitis // hereditary NPCC // MEN // BRCA

Question 32

features pancreatic cancer

Answer 32

painless jaundice (pale stool, dark urine, itch) // hepatomegaly, gallbladder mass, epgastric mass // vague symptoms eg anorexia, weigh loss // DM

Question 33

courvoisers law

Answer 33

painless obstructive jaundice + palpable bladder = NOT gallstones

Question 34

invx pancreatic cancer

Answer 34

raised ca199 // CT - double duct // USS

Question 35

mx pancreatic cancer

Answer 35

whipples (pancreaticoduodenectomy) + chemo // palliative = ERCP

Question 36

SE whipples

Answer 36

dumping syndrome + peptic ulcer