pancreas Flashcards
pancreatitis: define acute and chronic pancreatitis; recall causes, symptoms and signs, investigations and complications
define acute pacnreatitis
acute inflammatory process leading to necrosis of pancreatic parenchyma
signs and symptoms of acute pancreatitis
severe abdominal pain, nausea, vomiting, diarrhoea, fever, shock
diagnostic approach to pancreatitis (3)
history, examination, tests
6 sequential tests for diagnosing pancreatitis
simple, blood tests, complex blood test, simple imaging, cross sectional imaging (CT), invasive test
blood test for pancreatitis
high leukocyte (infection and inflammation), high urea and creatinine (renal failure), low albumin), high ALT (hepatocyte destruction), high CRP (inflammation), high amylase (pancreas - vs salivary gland)
imaging and complex imaging techniques
chest x-ray, abdominal x-ray, ultrasound, CT scan, MRCP
invasive tests
ERCP
3 scoring systems for pancreatitis
Ranson’s criteria, APACHE II, SIRS
SIRS 4 conditions
high or low temperature, tachycardia, hyperventilation (low PaCO2), high leukocyte
5 risk factors for severity of pancreatitis
necrotic (worse) vs non-necrotic, organ failure, age, co-morbidities, alcohol
causes of pancreatitis (GET SMASHED)
gallstones, ethanol, trauma, steroids, mumps, autoimmune, scorpion bite, hyperlipidaemia (or hypercalcaemia or hypothermia), ERCP, drugs (azathioprine, valproate)
systemic complications of pancreatitis
hypovolaemia, hypoxia, hypocalcaemia, hyperglycaemia (due to damage to islets of Langerhans), DIC, multiple organ failure
localised complications of pancreatitis
pancreatic necrosis, fluid collections (mature into pseudocysts), splenic vein thrombosis or pseudoaneurysm, chronic pancreatitis
5 supportive treatments for pancreatitis
fluids, painkillers, nutrition, organ support, management of complications
define chronic pancreatitis
progressive fibroinflammatory process of pancreas resulting in permanent structural damage, leading to impaired exocrine and endocrine function
