pancreas disorders

Question 1

cause of acute pancreatitis

Answer 1

biliary tract disease (female)

alcohol abus (male)

Question 2

acute pancreatitis risk factors

Answer 2

middle age
African american

Question 3

severity of acute pancreatitis

Answer 3

ranges from mild edema to severe hemorrhagic necrosis

Question 4

patho of pancreatitis

Answer 4

1. pancreatic cells are injured
2. pancreatic enzymes are activated (leak)
3. autodigestion (enzymes start to digest pancreas)
4. mild to severe pancreatitis

Question 5

what does the pancreas release?

Answer 5

insulin and glucagon to help with blood sugar control

Question 6

release of trypsin causes…

Answer 6

edema
necrosis
hemorrhage

Question 7

release of elastase causes…

Answer 7

hemorrhage

Question 8

release of phospholipase A causes…

Answer 8

fat necrosis

Question 9

release of kallikrein causes…

Answer 9

edema
vascular permeability
smooth muscle contraction
shock

Question 10

release of lipase causes…

Answer 10

fat necrosis

Question 11

clinical manifestations of acute pancreatitis

Answer 11

-LUQ or epigastric pain
-sudden onset
-pain may radiate to back
-abd tenderness

*N/V
*abd distention
*low blood sugar
*fever
*hypotension
*tachycardia
*jaundice

Question 12

what effects on labs does pancreatitis have?

Answer 12

increase in amylase, lipase, glucose, WBC

Question 13

abdominal presentation of acute pancreatitis

Answer 13

cyanosis or green-yellow/brown discoloration
-grey turners sign
-cullens sign

Question 14

grey turners sign

Answer 14

flanks

Question 15

Cullen’s sign

Answer 15

periumbilical

Question 16

complications of acute pancreatitis

Answer 16

pseudocyst
abscess
pulmonary complications
hypotension
tetany from low Ca
increased risk for clots

Question 17

pseudocyst

Answer 17

fluid (filled with necrotic products and secretions) that surrounds OUTSIDE of the pancreas

Question 18

what does a pseudocyst result in?

Answer 18

inflammation and scarring near the pancreas

may perforate and lead to peritonitis (rigid abd)

Question 19

clinical presentation of pseudocyst

Answer 19

similar to pancreatitis PLUS
palpable epigastric mass

Question 20

pancreatic abscess

Answer 20

large fluid filled sac INSIDE pancreas due to excess tissue death in pancreas

Question 21

clinical presentation of an abscess

Answer 21

similar to pancreatitis
PLUS
abd mass
high fever
leukocytosis

can become infected and spread

Question 22

chronic pancreatitis

Answer 22

inflammation in the pancreas that persists over weeks to months

Question 23

main cause of chronic pancreatitis

Answer 23

alcohol abuse - present in about 50% of alcoholics

Question 24

what happens to the pancreas with chronic pancreatitis?

Answer 24

necrosis (tissue death)
fibrosis (scare tissue)
loss of pancreatic enzymes and insulin
may continue even after alc use stops

Question 25

clinical manifestations of chronic pancreatitis

Answer 25

acute pancreatitis attacks with progressive sign of dysfunction after it subsides
CHRONIC pain

-DM
-malabsorption of fat
-weight loss

Question 26

morphine

Answer 26

relief of pain

Question 27

dicyclomine

Answer 27

antispasmodic (anticholinergic)

Question 28

antacids + H2 receptor antagonists

Answer 28

decrease HCl secretion in stomach which decreases secretion of pancreatic enzymes

Question 29

pancrelipase

Answer 29

replaced therapy for pancreatic enzymes
***CHRONIC pancreatitis ONLY!

Question 30

insulin

Answer 30

DM treatment, if it occurs

Question 31

pancrealipase

Answer 31

pancreatic enzyme replacement
used to reduce secretion of pancreatic enzymes

RARE SE

take with meals/snacks – aids in digestive process

Question 32

why would a patient with pancreatitis receive IV fluids?

Answer 32

replace fluid from fluid shifts

Question 33

why would a patient with pancreatitis receive fentanyl?

Answer 33

if morphine or hydromorphone is not enough for pain

Question 34

why would a patient with pancreatitis receive protonix?

Answer 34

proton pump inhibitor
blocks gastric secretion of parietal cells

Question 35

why would a patient with pancreatitis receive lovenox?

Answer 35

decrease risk of DVT and PE because at risk for clotting

Question 36

chronic pancreatitis may lead to

Answer 36

DM