Pancreas

Question 0

Three stages of pancreatitis

Answer 0

1 intrapancreatic enzyme activation and acinar cell injury

2 chemoattraction of neutrophils

3 release of proteolytic enzymes onto distant organs

Question 1

SIRS criteria

Answer 1

Systemic Inflammatory Response Syndrome,

Temp 38
Hr > 90bpm
Tachypnea >20 breath per min
WBC 12x10^9/L

Question 2

Two most common causes of acute pancreatitis

Answer 2

Gallstones, alcohol

Question 3

Infectious causes of acute pancreatitis

Answer 3

CMV, mumps, rubella, coxB

Question 4

Classic presentation of AC

Answer 4

Pain in epigastrum and radiates to back
Nausea and vomiting
Fever
Hypotension or shock

Question 5

What are Turner sign and Cullen sign?

Answer 5

Blushing color around flanks (turner) and umbilicus (cullen)

Question 6

Signs present in severe but not mild acute pancreatitis

Answer 6

Rebound tenderness
Bowl sounds are absent
Ascites or shifting dullness

Question 7

Laboratory marker of choice for acute pancreatitis

Answer 7

Serum Amylase (3x or more original value)

Urinary Amylase (lasts longer than serum amylase)

Serum Lipase (most accurate b/c solely pancreatic origin)

Question 8

Amylase Creatinine Clearance Ratio (ACR)

normal and AP values

Answer 8

normal: 3.8-5.3%
AP: 5-6%

Question 9

What a CT scan can show about AP

Answer 9

***Pancreatic necrosis (lack of enhancement after contrast medium bolus injection)

inflammation, thrombosis, fluid collection

Question 10

Cause of pancreatic abscess?

Answer 10

Gas-forming microorganisms

Question 11

Drug to relax sphincter of oddi

Answer 11

Magnesium sulfate