pancreas Flashcards

1
Q

What is Acute pancreatitis?

A

acute inflammation of the pancreas, releasing exocrine enzymes that cause auto digestion of organs (attacks the pancrease)

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2
Q

What are the pancreatic enzymes that are related? and what do they do in acute pancreatitis?

A

amylase and lipase (increased)

They attack the pancreas and surrounding tissues/organs.

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3
Q

What is the most commonly presented symptom associated with acute pancreatitis?

A

mid-epigastric or left upper quadrant pain that radiates to the back

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4
Q

Major causes of Acute pancreatitis?

A
  1. Alcohol (60-75%)
  2. Gallstones (25-40%)
  3. post ERCP
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5
Q

Other causes of Acute pancreatitis?

A

Drugs (corticosteroids)
IBD
Metabolic (incres in calcium, increase in triglycerides, dec temp)
infections

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6
Q

General principle for diagnosis Acute pancreatitis?

A

A diagnosis of exclusion, so must be ruled out when PT’s come in with abdominal pain

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7
Q

What are my investigations for Acute pancreatitis?

A
  • FBC (looking for > serum amylase and lipase, 150 indicates pancreatitis
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8
Q

clinical presentations, signs and symptoms for Acute pancreatitis?

A
  • > serum and lipase
  • Mid epigastric or left upper quadrant pain that radiates to back
  • sudden on set of vomiting and nausea
  • tachycardia
  • dehydrated
  • > 55
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9
Q

What other system is Acute pancreatitis related to?

A

respiratory system, failure

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10
Q

Treatment/management plan for Acute pancreatitis

A
  • pain relief…give analgesia
  • intravenous fluids
  • Antibiotics in case of suspected necrosis/infection
  • Cholecystectomy (PT’s with suspected Gallstones)
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11
Q

What is anorexia

A

eating disorder, PT tries to keep weight as low as possible

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12
Q

What is pyrexia

A

Fever

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13
Q

What is chronic pancreatitis?

A

continuing inflammation of the pancreas, characterised by glandular destruction and irreversibly damage

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14
Q

In terms of incidence who is more prevalent to Chronic pancreatitis

A

M>F

aged 35-50 year old

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15
Q

What are the main characteristic of Chronic pancreatitis?

A
  • recurrent, persisted abdominal pain
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16
Q

What is chronic pancreatitis more likely to affect in comparison to acute pancreatitis?

A

Chronic - endocrine and exocrine functions of the pancreas

Acute - exocrine functions of the pancreas

17
Q

80% of chronic pancreatitis are due to…?

A

Alchohol

18
Q

What are the other causes of chronic pancreatitis?

A
  1. Genetic predisposition: Cystic fibrosis (mutation in CFTR gene) & haemochromatosis
  2. Ductal obstruction: Tumors, stones
19
Q

What is haemochromatosis?

A

A condition in which the body absorbs too much iron

20
Q

What is hypercalcemia

A

condition in which calcium levels are above normal

21
Q

What genes are most susceptible to pancreatitis

A
  1. PRSS1 gene
  2. CFTR
  3. SPINK1
22
Q

What is the CFTR gene?

A

cystic fibrosis transmembrane conductance regulator

23
Q

What are the clinical features of Chronic pancreatitis?

A
  1. Abdominal pain
    • exacerbated by food
  2. weight loss
  3. exocrine & endocrine insufficiency
    4.
24
Q

Exocrine functions?

A

the release of enzymes that digest proteins, carbs and fats

- so we get Malabsorption, diarrhoea, steatorrhoea and protein deficiency

25
Q

Endocrine functions?

A

secretion of hormone, insulin, controlling blood sugar

26
Q

What are my investigations for Chronic pancreatitis?

A
  • CT of abdomen (AXR; Abdominal x-ray)
  • ultrasound: size, cysts and ducts
  • Blood test: serum levels
27
Q

What would an AXR show in case of chronic pancreatitis?

A

calcification of pancreas

28
Q

Management/Treatment for Chronic pancreatitis?

A
  • pain relief (analgesia)

- pancreatic enzyme supplements

29
Q

In terms of carcinoma of the pancreas who is more susceptible?

A

M>F

60-80 year olds

30
Q

75% of Pancreatic carcinoma are due to…?

A

Duct cell mutinous adenocarcinoma

31
Q

Clinical presentation of Pancreatic cancer?

A

-Upper Abdominal pain (75% in head and body of pancreas)

  • Jaundice
  • weight loss
  • anorexia
  • fatigue
  • fever
32
Q

What are the physical signs of Chronic pancreatitis?

A
  • jaundice
  • abdominal mass
  • abdominal tenderness
33
Q

Management for Pancreatic cancer?

A
  • whipples procedure

- Pain relief/ control

34
Q

In terms of acute Vs chronic pancreatitis how are the levels of amylase and lipase?

A

acute: increased
chronic: could be normal levels