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GI > Pancreatic Disease > Flashcards

Pancreatic Disease Flashcards

1
Q

What is acute pancreatitis?

A

Inflammation of the pancreas

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2
Q

What are the causes of acute pancreatitis?

A 
Alcohol abuse 
Gallstones 
Idiopathic 
Trauma 
Drugs (steroids, diuretics, azathioprine)
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3
Q

What are the symptoms of acute pancreatitis?

A

Upper abdominal pain
Jaundice
Sudden onset
Grey Turner’s/ Cullen’s signs

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4
Q

What are the clinical signs of acute pancreatitis?

A

Elevated serum amylase levels

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5
Q

What are the investigations used to diagnose acute pancreatitis?

A

Bloods
AXR and CXR
Abdominal ultrasound
CT

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6
Q

How is the severity of acute pancreatitis accessed?

A

Glasgow criteria, score above 3 is considered severe

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7
Q

What is the general management strategy for acute pancreatitis?

A 
Analgesia 
Oxygen 
Naso gastric tube 
IV fluids 
Blood transfusion 
Monitor urine output 
May need insulin
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8
Q

What is the management of acute pancreatitis caused by pancreatic necrosis?

A

CT guided aspiration followed by antibiotics and surgery

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9
Q

What is the management of acute pancreatitis caused by gallstones?

A

EUS/MRCP/ERCP

Cholecystectomy

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10
Q

What is the management of acute pancreatitis caused by abscess?

A

Antibiotics and drainage

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11
Q

What is a pseudocyst?

A

Fluid collection without an epithelial lining

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12
Q

What is the clinical sign of a pseudocyst?

A

Persistent hyperamylasaemia and/or pain

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13
Q

How is a pseudocyst diagnosed?

A

Ultrasound or CT

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14
Q

What are the complications of a pseudocyst?

A

Jaundice
Infection
Haemorrhage
Rupture

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15
Q

What is the treatment for a pseudocyst?

A

Endoscopic drainage or surgery

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16
Q

What is chronic pancreatitis?

A

Continuing inflammation of pancreas by irreversible glandular destruction, typically causing pain and permanent loss of function

17
Q

What are the causes of chronic pancreatitis?

A

Alcohol
Cystic fibrosis
Hereditary pancreatitis
Hypercalcaemia

18
Q

What is the pathogenesis of chronic pancreatitis?

A 
Duct obstruction (calculi, inflammation, protein plugs) 
Abnormal sphincter of Oddi function 
Genetic polymorphism
19
Q

What is the pathology of chronic pancreatitis?

A

Glandular atrophy and replacement by fibrous tissue
Ducts become dilated, tortuous and strictured
Inspissated secretions may calcify
Splenic, superior mesenteric and portal veins may thrombose

20
Q

What are the clinical features of chronic pancreatitis?

A 
Abdominal pain 
Weight loss 
Steatorrhoea
Jaundice 
Portal hypertension 
GI haemorrhage
21
Q

What are the investigations for chronic pancreatitis?

A 
AXR 
Ultrasound 
EUS 
CT 
Bloods 
Pancreatic function tests
22
Q

What is the management of chronic pancreatitis?

A 
Avoid alcohol
Opiate analgesia 
Coeliac plexus block 
Pancreatic enzyme supplements 
Surgery in selected cases
23
Q

What is the endocrine/exocrine management of chronic pancreatitis?

A

Low fat diet
Pancreatic enzyme supplements
Vitamin supplements
Insulin for diabetes

24
Q

What is the most common carcinoma of the pancreas?

A

Duct cell mucinous adenocarcinoma

25
Q

What are the other less common carcinomas of the pancreas?

A

Carcinosarcoma
Cystadenocarcinoma
Acinar cell

26
Q

What are the clinical features of pancreatic carcinoma?

A 
Upper abdominal pain
Jaundice 
Weight loss 
Fatigue 
Diarrhoea/ steatorrhoea 
Ascites 
Portal hypertension 
Tender subcutaneous fat nodules
27
Q

What are the physical signs of pancreatic carcinoma?

A 
Hepatomegaly 
Jaundice 
Abdominal mass 
Abdominal tenderness 
Ascites 
Splenomegaly 
Supraclavicular lymphadenopathy 
Palpable gallbladder
28
Q

What is the management of pancreatic carcinoma?

A

Radical surgery (Whipple)
Palliation of jaundice
Pain control
Chemotherapy

GI (27 decks)

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