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GI > Pancreas > Flashcards

Pancreas Flashcards

Conditions

1
Q

What is acute pancreatitis?

A

Acute inflammation of the pancreas

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2
Q

How does acute pancreatitis present?

A 
Abdominal pain
Vomiting
Pyrexia
Jaundice
Retroperitoneal haemorrhage
Hypoglycaemia
Hyperglycaemia
Effusions
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3
Q

What might present in acute pancreatitis history?

A 
Alcohol abuse 60-75%
Gallstones 25-40%
Trauma
Drugs
Viruses
Metabolic
Autoimmune
Idiopathic ~10%
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4
Q

What investigations can be done in acute pancreatitis?

A 
Endoscopy
Cholangiopancreatography
Endoscopic ultrasound
Blood tests: AMY, LIPA, FBC, EUC, LFT, Ca2+, PGLU, ABG, FLIP, COAG
Abdominal and Chest X-Ray
CT
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5
Q

What can be done to manage acute pancreatitis?

A 
Analgesia
IV Fluids
NG tube
Oxygen
Possibly insulin
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6
Q

What complications can arise from acute pancreatitis?

A

Abscess

Pseudocyst

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7
Q

What is chronic pancreatitis?

A

Continuing inflammatory disease characterised by irreversible glandular destruction and typically causing pain

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8
Q

Who is usually more affected by chronic pancreatitis?

A

Males > Females

Age 35-50

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9
Q

What might present in chronic pancreatitis history?

A 
Alcohol
Cystic fibrosis
Congenital abnormalities (annular pancreas, pancreas divisum)
Hereditary pancreatitis (rare)
Hypercalcaemia
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10
Q

How does chronic pancreatitis present?

A

Early disease is asymptomatic
Abdominal pain
Weight loss
Steatorrhoea
Exocrine insufficiency leads to fat and protein malabsorption
Endocrine deficiency can lead to diabetes (30%)

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11
Q

What investigations are carried out in chronic pancreatitis?

A 
Plain abdominal x-ray
Ultrasound
Endoscopic US
CT
Blood tests: AMY, LFT, PT, PGLU, ALB, B12
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12
Q

How can chronic pancreatitis be managed?

A 
Avoid alcohol
Low fat diet
Pancreatic enzyme supplementation
Opiate analgesia
Coeliac plexus block
Endoscopic treatment of pancreatic duct stones and strictures
Surgery
Insulin for DM
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13
Q

What is the prognosis for chronic pancreatitis?

A

50% 10yr survival if continue alcohol intake

80% 10yr survival if abstinent

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14
Q

What is the most common form of pancreatic cancer?

A

75% ductal adenocarcinoma

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15
Q

What types of pancreatic cancer are there?

A

Ductal adenocarcinoma
Cystadenocarcinomas
Acinar cell carcinoma

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16
Q

How might pancreatic cancer present?

A 
Abdominal pain (mass/tenderness)
Painless obstructive jaundice
Weight loss
Anorexia
Fatigue
Steatorrhoea/diarrhoea
Nausea and vomiting
Tender subcutaneous nodules (metastatic fat necrosis)
Ascites
Portal hypertension
Splenomegaly
17
Q

What investigations can be done in suspected pancreatic cancer?

A

Ultrasound
CT
MRI
Endoscopic ultrasound

18
Q

What is used to manage pancreatic cancer?

A 
Most have advanced disease
Pancreatoduodenectomy (Whipple's procedure)
Palliation of jaundice
Pain control
Chemotherapy only in trials
19
Q

What is the prognosis of someone with pancreatic cancer?

A

Inoperable: mean survival ~6 months, 1% 5yr survival
Operable: 15% 5yr survival

GI (12 decks)

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