Pancreas

Question 1

What is Acute pancreatitis

Answer 1

inflm of the pancreas

Question 2

What is the most common cause of pancreatitis

Answer 2

Auto digestion (enzymes digesting str components of Pancreas)

Question 3

Can pancreatitis be caused by an infection

Answer 3

Yes

Question 4

Is the pancreas mainly exocrine or endocrine

Answer 4

exocrine (out to GI)

Question 5

How serious is pancreatitis

Answer 5

Can be life threatening (Often self limiting, but very dangerous)

Question 6

Etiology of Pancreatitis (5)

Answer 6

Alcohol abuse (~70%)
Gallstones
Idiopathic(~10%)
Others (Pancreatic trauma, drugs)

Question 7

How and where are pancreatic enzymes activated

Answer 7

By bile in the duodenum

Question 8

Basic pathology of autosuggestion

Answer 8

Impeded Bile flow -> premature activation of es -> Es cause damage

Proteins and lipids which are structural will be broken down by Es- auto digestion ->(inflm exudate) Necrosis and Hemorrhage of blood vessels in pancreas

Question 9

How does alcohol effect autosuggestion

Answer 9

Alcohol increases pancreatic secretions (OH abuse)

Alcohol also constricts sphincter (of Oddi) leading to duodenum

Bile and secretion mix back up into pancreas

Question 10

In what timeframe does pancreatitis MNFT

Answer 10

Acute onset (likely after large meal or night of drinking)

But it has likely been a festering problem fro some time

Question 11

Objective MNFTS on physical

Answer 11

Severe abd pain ( Epigastric and Radiates to the back )

3rd spacing (lots) Into abd cavity (ascites)

Question 12

Likely complication from 3rd spacing?

Answer 12

vascular collapse and shock possible from Hypovolemia (lots of and inflm)

Question 13

MNFT apparent with lab work

Answer 13

Increased blood amylase and lipase. Es excreted by pancreas, provide marker when in blood

Lipase better because amylase is also produced in salivary gland. Lipase more specific Es to pancreas

Question 14

Tx for mild

Answer 14

~ 1 week recovery (monitoring is key intervention)

NPO (limits bile production), pain fluids/electrolytes, correct metb abn (fix potential issue with insulin)

Question 15

Tx for severe

Answer 15

ICU
o Third spacing- renal, circulatory, hepatobiliary support (underlying cause)
o IV opiates
o Sx (obstruction or hemorrhage)

Question 16

Describe ducts system from pancreas

Answer 16

Main pancreatic duct joins the common bile duct at the hepatopancreatic ampulla (ampulla of vader, through major duodenal papilla (aka sphincter of do) into duodenum.

There a sphincter at end of pancreatic duct

Some people have an accessory pancreatic duct which also empties into duodenum