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Y5 colorectal > pancreas > Flashcards

pancreas Flashcards

1
Q

pathophysiology of acute pancreatitis

A

processes cause excess exocrine function, increase release of digestive enzymes from acinar cells, cause an inflammation response, increase vascular permeability and fluid shift

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2
Q

causes of acute pancreatitis

A

Idiopathic
Gallstone
Ethanol
Trauma
Scorpions
Mumps
Autoimmune (sjogrens)
Steroids
Hypercalcaemia
ERCP
Drugs - NSAID, furosemide, azathioprine

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3
Q

why does pancreatitis cause hypocalcaemia

A

lipase, liquefactive fat necrosis - fatty acids then bind calcium to form chalky deposits

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4
Q

why does pancreatitis cause haemorrhage (cullens - central, grey turners - flanks)

A

protease breakdown vessels

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5
Q

when is the modified glasgow done for acute pancreatitis

A

on admission and after 48 hours

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6
Q

what is the modified glasgow

A

PaO2 <8
Age >55
Neuts > 15
Calcium low
Renal - high urea
Enzymes (raised AST - deranged LFT suggest a gallbladder cause) / raised LDH
Albumin low
sugar >10

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7
Q

IX for pancreatitis

A

bloods - including LFT, U+E, FBC, glucose, calcium, serum lipase and amylase
USS to look for gallstones
CT with contrast

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8
Q

MX of pancreatitis

A

supportive - IV analgesia, NGT, NBM, IV fluids!!!

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9
Q

what is a pseudocyst

A

4 weeks after acute pancreatitis persistent high amylase, epigastric pain + well circumscribed mass –> some resolve and some need surgical removal

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10
Q

complications of acute pancreatitis

A

ARDs, DIC, hypocalcaemia

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11
Q

what is chronic pancreatitis

A

progressive and irreversible fibrotic changes to the pancreas

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12
Q

how does chronic pancreatitis present

A

steatorrhoea and cachexia (due to malabsorption), chronic epigastric pain, diabetes

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13
Q

cause of chronic pancreatitis

A

CF/ alcohol

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14
Q

IX for chronic pancreatitis

A

faecal elastase will be low, CT will show fibrotic changes
(AMYLASE MAY NOT BE RAISED)

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15
Q

MX of chronic pancreatitis

A

ADEK, creon, analgesia

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16
Q

pancreatitis cancer is most common where

A

in the head of the pancreas

17
Q

main presenting symptoms of pancreatic cancer

A

painless jaundice and weight loss (may have courvoisier law)

18
Q

if pancreatitis cancer is in the tail or the body of the pancreas how may it present

A

with diabetes

19
Q

what is a whipples procedure vs modified whipples

A

whipples = pancreatoduodenectomy (includes removal or pylorus of stomach)
modified whipples keeps pylorus

20
Q

2WW referral for jaundice

A

over 40s

21
Q

imaging for jaundice

A

USS and ERCP

Y5 colorectal (8 decks)

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