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Patho 1 > Pancreas > Flashcards

Pancreas Flashcards

1
Q

Acute pancreatitis

A

inflammation of the pancreas that is mild and often spontaneously resolves

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2
Q

What percentage of acute pancreatitis ends patients in the hospital?

A

20%

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3
Q

Acute pancreatitis patho

A

obstruction of outflow of pancreatic enzymes often related to pancreatic and common bile duct obstruction (often gallstones)

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4
Q

Causes of acute pancreatitis

A

Alcohol, drugs, viral infection

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5
Q

What does build up of enzymes cause?

A

Autodigestion of pancreatic cells which causes inflammation

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6
Q

Complications of autodigestion of the pancreatic cells

A

Necrosis, fat necrosis, coagulopathy, vascular damage

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7
Q

What does elevated trypsin cause

A

edema, hemorrhage, necrosis

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8
Q

What does elevated elastase cause

A

hemorrhage

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9
Q

What does elevated phospholipase A cause

A

Fat necrosis

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10
Q

What does elevated kallikrein cause

A

edema, vascular permeability, shock, smooth muscle contractions

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11
Q

What does vascular permeability cause

A

Fluid seeps into the pancreas which can cause ascites

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12
Q

What does smooth muscle contractions cause

A

pain

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13
Q

What is the cause of shock with acute pancreatitis

A

vascular permeability

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14
Q

What does elevated lipase cause

A

fat necrosis

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15
Q

Necrosis

A

Death and breakdown of tissues

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16
Q

s/s acute pancreatitis

A

severe epigastric pain, N/V, hypoactive bowel sounds, ab distension, fever, hypotension, tachycardia, jaundice, ecchymosis

17
Q

Characteristics of acute pancreatitis pain

A
  • sudden onset
  • tender abdomen
  • guarding
  • may radiate to back
18
Q

What causes acute pancreatitis pain

A

edema - distention of pancreatic ducts and capsules and irritation of peritoneum and biliary tract

19
Q

Elevated labs with acute pancreatitis

A

amylase, lipase, WBCs

20
Q

How does acute pancreatitis affect glucose

A

Glucose can be high or low (depends which cells are autodigested)

21
Q

Ecchymosis

A

Cyanosis or green-yellow/brown color on abdomen

22
Q

Grey Turners

A

ecchymosis on the flanks

23
Q

Cullen sign

A

ecchymosis in the periumbilical area

24
Q

What kind of pancreatitis causes ecchymosis

A

Hemorrhagic pancreatitis

25
Q

Complications of acute pancreatitis

A

abscess, pseudocyst, pulmonary compromise, tetany, hypotension (shock)

26
Q

Pseudocyst

A
  • Fluid filled cavity SURROUNDING the outside pancreas that are made of necrotic products and secretions, cause more inflam and scarring
  • visible on a CT
  • may be palpable epigastric mass that can cause peritonitis if it perforates - may need surgery to prevent
27
Q

Abscess

A
  • Large fluid filled cavity in pancreas that can cause infection or perforation
  • Abdominal mass, inc fever, inc leukocytosis
  • cause is often necrotic pancreatic hemorrhage
28
Q

Why does tetany happen with acute pancreatitis?

A

Lipase causes fat necrosis which releases FFA that binds to calcium deposits in the peritoneum and causes dec calcium

29
Q

Chronic pancreatitis

A

Progressive fibrotic disease of the pancreas

30
Q

Most often cause of chronic pancreatitis

A

Alcohol

31
Q

Patho of alc chronic hepatitis

A

Toxic metabolites release inflammatory cytokines and cause destruction of acinar cells and islet of langerhans

32
Q

Risk factors for chronic pancreatitis

A

Genetics, SMOKE, gallstone obstruction, Alcohol

33
Q

CM for chronic pancreatitis

A
  • attacks of acute pancreatitis with progressive signs of dysfunction after attacks subside
  • abdominal pain and weight loss
  • diabetes r/t loss of islet of Langerhans
  • issues with nutrition, especially fat abs–wt loss
  • pancreatic psuedocysts
34
Q

Pharm for pancreatitis

A

Opioids, Antispasmodics, antacids, H2 receptor antagonists, pancrelipase, insulin or glucagon

35
Q

Dicyclamine

A

Antispasmodic (anti-ACh agent) that decreases spasming bile ducts

36
Q

Antacids

A

Neutralize Hcl secretion in stomach which dec secretion of pancreatic enzymes

37
Q

H2 receptor antagonists

A

basically antacids

38
Q

Pancrelipase

A

Replaces panc enzymes (chronic only)

Patho 1 (37 decks)

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