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KaBoom > Pancreas - Part 3 > Flashcards

Pancreas - Part 3 Flashcards

1
Q

What remains increased longer than serum amylase in episodes of acute pancreatitis?

A

Urine amylase

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2
Q

What is the normal range for serum lipase?

A

10-140U/L

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3
Q

What does serum lipase increase with? (6)

A
  1. Pancreatitis
  2. Obstruction of the pancreatic duct
  3. Pancreatic carcinoma
  4. Acute cholecystitis
  5. Cirrhosis
  6. Severe renal disease
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4
Q

What is the normal range of glucose in a fasting patient?

A

< 100mg/dL

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5
Q

What is the normal range of glucose in a patient 2 hours postprandial?

A

< 145 mg/dL

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6
Q

What does glucose increase with? (3)

A
  1. Severe diabetes mellitus
  2. Chronic liver disease
  3. Overactivity of several of the endocrine glands
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7
Q

What does glucose decrease with?

A

Tumours of the islets of Langerhans in the pancreas

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8
Q

What are causes of acute pancreatitis? (5)

A
  1. Biliary disease
  2. Alcohol abuse
  3. Trauma
  4. Peptic ulcer disease
  5. Idiopathic
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9
Q

What are the clinical findings of acute pancreatitis? (4)

A
  1. Abrupt onset of epigastric pain
  2. Nausea/vomiting
  3. Elevated lipase and amylase
  4. Paralytic ileus
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10
Q

What is the US appearance of acute pancreatitis? (4)

A
  1. Normal findings
    - 30%
  2. Decrease in parenchymal
    echogenicity
  3. Smooth borders
  4. Enlargement
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11
Q

What are 2 differential diagnosis for acute pancreatitis?

A
  1. Normal pancreas

2. Neoplasm

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12
Q

Chronic pancreatitis

A

Repeated, prolonged, or persistent attacks of pancreatitis

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13
Q

What are the causes of chronic pancreatitis? (2)

A
  1. Hypocalcemia

2. Hyperlipidemia

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14
Q

What are the clinical findings of chronic pancreatitis? (5)

A
  1. Chronic RUQ or epigastric pain
  2. Nausea/vomiting
  3. Weight loss
  4. Abnormal glucose tolerance test
  5. Normal amylase and lipase values
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15
Q

What is the US appearance of chronic pancreatitis? (6)

A
  1. Increase in parenchymal echogenicity
  2. Irregular borders
  3. Calcifications
  4. Pseudocyst formation
  5. Atrophy
  6. Prominent pancreatic duct
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16
Q

What are 2 differential diagnosis of chronic pancreatitis?

A
  1. Fatty replacement

2. Neoplasm

17
Q

What are 5 complications of pancreatitis?

A
  1. Abscess
  2. Duodenal obstruction
  3. Hemorrhage
  4. Phlegmon
  5. Pseudocyst
18
Q

Why does an abscess develop result from?

A

An infection of the necrotic pancreas

19
Q

When can an abscess begin to form following an episode of acute pancreatitis?

A

2-4 weeks

20
Q

What are the clinical features of an abscess? (4)

A
  1. Abdominal pain
  2. Leukocytosis
  3. Nausea/vomiting
  4. Fever
21
Q

What is the US feature of an abscess? (3)

A
  1. Ranges from anechoic to echogenic
  2. Irregular or smooth borders
  3. Fluid-debris levels
22
Q

Duodenal obstruction

A

High protein concentration in the pancreas enzymes can irritate the duodenum

23
Q

What are clinical findings of duodenal obstruction? (4)

A
  1. Abdominal pain
  2. Abdominal distention
  3. Nausea/vomiting
  4. Constipation
24
Q

What is the US appearance of duodenal obstruction?

A

Limited bowel peristalsis

25
Q

Hemorrhage

A

Rapid development of inflammation causing necrosis and hemorrhage

26
Q

What are the clinical findings of hemorrhage? (4)

A
  1. Severe abdominal pain
  2. Nausea/vomiting
  3. Elevated amylase
  4. Decrease in hematocrit level
27
Q

What is the US appearance of hemorrhage? (3)

A
  1. Well-defined homogeneous mass
  2. Cystic mass with debris
  3. Fluid-debris levels
28
Q

Phlegmon

A

Extension of pancreatic inflammation into the peripancreatic tissues

29
Q

What are clinical findings of phlegmon? (3)

A
  1. Severe abdominal pain
  2. Nausea/vomiting
  3. Elevated amylase
30
Q

What is the US appearance of phlegmon? (3)

A
  1. Hypo echoic solid mass adjacent to the pancreas
  2. Posterior acoustic enhancement Irregular borders
  3. Usually involves the lesser sac, transverse mesocolon, and anterior pararenal space
31
Q

Pseudocyst

A

Focal collection of inflammatory necrotic tissue, blood, and pancreas secretions

32
Q

Where is a pseudocyst most often located?

A

In the lesser sac followed by the anterior pararenal space

33
Q

What are the clinical findings of pseudocyst? (3)

A
  1. Abdominal pain
  2. Palpable mass
  3. Persistent elevated amylase
34
Q

What is the US appearance of pseudocyst? (3)

A
  1. Anechoic or complex mass
  2. Well-defined borders
  3. Variable shape

KaBoom (81 decks)

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