pancreas Flashcards
What is Acute pancreatitis?
acute inflammation of the pancreas, releasing exocrine enzymes that cause auto digestion of organs (attacks the pancrease)
What are the pancreatic enzymes that are related? and what do they do in acute pancreatitis?
amylase and lipase (increased)
They attack the pancreas and surrounding tissues/organs.
What is the most commonly presented symptom associated with acute pancreatitis?
mid-epigastric or left upper quadrant pain that radiates to the back
Major causes of Acute pancreatitis?
- Alcohol (60-75%)
- Gallstones (25-40%)
- post ERCP
Other causes of Acute pancreatitis?
Drugs (corticosteroids)
IBD
Metabolic (incres in calcium, increase in triglycerides, dec temp)
infections
General principle for diagnosis Acute pancreatitis?
A diagnosis of exclusion, so must be ruled out when PT’s come in with abdominal pain
What are my investigations for Acute pancreatitis?
- FBC (looking for > serum amylase and lipase, 150 indicates pancreatitis
clinical presentations, signs and symptoms for Acute pancreatitis?
- > serum and lipase
- Mid epigastric or left upper quadrant pain that radiates to back
- sudden on set of vomiting and nausea
- tachycardia
- dehydrated
- > 55
What other system is Acute pancreatitis related to?
respiratory system, failure
Treatment/management plan for Acute pancreatitis
- pain relief…give analgesia
- intravenous fluids
- Antibiotics in case of suspected necrosis/infection
- Cholecystectomy (PT’s with suspected Gallstones)
What is anorexia
eating disorder, PT tries to keep weight as low as possible
What is pyrexia
Fever
What is chronic pancreatitis?
continuing inflammation of the pancreas, characterised by glandular destruction and irreversibly damage
In terms of incidence who is more prevalent to Chronic pancreatitis
M>F
aged 35-50 year old
What are the main characteristic of Chronic pancreatitis?
- recurrent, persisted abdominal pain
What is chronic pancreatitis more likely to affect in comparison to acute pancreatitis?
Chronic - endocrine and exocrine functions of the pancreas
Acute - exocrine functions of the pancreas
80% of chronic pancreatitis are due to…?
Alchohol
What are the other causes of chronic pancreatitis?
- Genetic predisposition: Cystic fibrosis (mutation in CFTR gene) & haemochromatosis
- Ductal obstruction: Tumors, stones
What is haemochromatosis?
A condition in which the body absorbs too much iron
What is hypercalcemia
condition in which calcium levels are above normal
What genes are most susceptible to pancreatitis
- PRSS1 gene
- CFTR
- SPINK1
What is the CFTR gene?
cystic fibrosis transmembrane conductance regulator
What are the clinical features of Chronic pancreatitis?
- Abdominal pain
- exacerbated by food
- weight loss
- exocrine & endocrine insufficiency
4.
Exocrine functions?
the release of enzymes that digest proteins, carbs and fats
- so we get Malabsorption, diarrhoea, steatorrhoea and protein deficiency
Endocrine functions?
secretion of hormone, insulin, controlling blood sugar
What are my investigations for Chronic pancreatitis?
- CT of abdomen (AXR; Abdominal x-ray)
- ultrasound: size, cysts and ducts
- Blood test: serum levels
What would an AXR show in case of chronic pancreatitis?
calcification of pancreas
Management/Treatment for Chronic pancreatitis?
- pain relief (analgesia)
- pancreatic enzyme supplements
In terms of carcinoma of the pancreas who is more susceptible?
M>F
60-80 year olds
75% of Pancreatic carcinoma are due to…?
Duct cell mutinous adenocarcinoma
Clinical presentation of Pancreatic cancer?
-Upper Abdominal pain (75% in head and body of pancreas)
- Jaundice
- weight loss
- anorexia
- fatigue
- fever
What are the physical signs of Chronic pancreatitis?
- jaundice
- abdominal mass
- abdominal tenderness
Management for Pancreatic cancer?
- whipples procedure
- Pain relief/ control
In terms of acute Vs chronic pancreatitis how are the levels of amylase and lipase?
acute: increased
chronic: could be normal levels
