Pancreas

Question 0

What are some of the laboratory findings associated with pancreatitis?

Answer 0

Increased amylase

Reduced calcium

Hyperglycaemia

Increased ALP

Increased bilirubin

Question 1

What are some of the symptoms of acute pancreatitis?

Answer 1

Inflammatory process caused by effects of enzymes released from pancreatic acini due to duct obstruction/acinar damage

Proteases destroy tissues, lipases cause fat necrosis, and elastase causes blood vessel obstruction (oedema, haemorrhage, necrosis)

• severe pain
• vomiting
• dehydration
• shock
• SIRS
• ecchymosis (bruise caused by release of blood into tissues - injury or spontaneous)
• ileus (intestinal obstruction)

Question 2

What are some of the causes of acute pancreatitis?

Answer 2

GET SMASHED

Gallstones 
Ethanol 
Trauma 
Steroids 
Mumps 
Autoimmune 
Scorpion bite 
Hyperlipidaemia 
ERCP/iatrogenic 
Drugs

Question 3

What are some of the symptoms of chronic pancreatitis?

Answer 3

Parenchymal destruction, fibrosis, loss of acini, duct stenosis

Pain
Malabsorption: steatorrhoea, reduced albumin, weight loss
Diabetes mellitus
Jaundice (stenosis of bile duct)

Question 4

What are some of the causes of chronic pancreatitis?

Answer 4

Chronic alcoholism

Cystic fibrosis

Inherited

Biliary disease

Question 5

What is the aetiology, signs, and symptoms associated with pancreatic carcinoma?

Answer 5

Aetiology:

• smoking
• beta-napthylamine
• benzidine
• familial pancreatitis

Signs & symptoms: (initially asymptomatic -> late presentation)

• obstructive jaundice -> palpable gallbladder
• pain (cancer erodes into nerves)
• vomiting (gastric outlet obstruction
• carcinomatosis (spread of cancer throughout body)
• malabsorption
• diabetes

Question 6

What hormones stimulate enzyme and bicarbonate secretion from the pancreas?

Answer 6

Cholecystokinin (CCK) stimulates enzyme rich secretions (secreted by duodenal APUD cells)

Secretin stimulates bicarbonate rich secretions (secreted by ducts cells)