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Year 2 GI (JK) > Pancreatic disease > Flashcards

Pancreatic disease Flashcards

1
Q

Define acute pancreatitis

A

The acute inflammation of the pancreas which may be associated with multi-organ failure

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2
Q

What are the main causes of acute pancreatitis?

A

alcohol
gallstones
trauma, infection, post op, drugs, autoimmune, carcinoma, idiopathic

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3
Q

Is it the exocrine or endocrine part associated with acute pancreatitis?

A

exocrine

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4
Q

What is the brief pathology behind acute pancreatitis?

A

insult to the pancreas leading to enzyme release from the pancreas - autodigestion - leading to oedema, fat necrosis, haemorrhage

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5
Q

What are some clinical features of AP?

A

abdominal pain radiating to the back, vomiting, fever, tachycardia, jaundice, retroperitoneal haemorrhage

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6
Q

What do EUS look for in AP?

A

gallstones not picked up by CT

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7
Q

What blood tests are useful in AP?

A

serum amylase, FBC, U+E, LFTs

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8
Q

What imaging techniques are useful in AP?

A

contrast enhanced CT, abdominal ultrasound, AXR, CXR

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9
Q

What is the contraindication of contrast enhanced CT in AP?

A

many patients also have renal disease

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10
Q

What is important to assess in AP before treating?

A

severity

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11
Q

A score over what in the Glasgow criteria suggests severe pancreatitis?

A

3

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12
Q

A CRP over what mg indicates severe pancreatitis?

A

150mg

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13
Q

What are some things taken into consideration for the Glasgow criteria?

A

white cell count, blood glucose, blood urea, AST, albumin and arterial PO2

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14
Q

general management for AP?

A

analgesia, IV fluids, blood transfusion, NG tube, catheter to monitor urine output, oxygen, insulin

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15
Q

Management for pancreatic necrosis in AP?

A

antibiotics, drainage - CT guided aspiration, surgery

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16
Q

Management for gallstones in AP?

A

EUS/MRCP/ERCP

Cholecystectomy

17
Q

Complications of AP?

A

abscess, pseudocyst

18
Q

What is a pseudocyst?

A

fluid collection without an epithelial lining

19
Q

define chronic pancreatitis

A

continuing inflammatory disease of the pancreas characterised by irreversible glandular destruction and typically causing pain and/or permanent loss of function

20
Q

What are some causes of chronic pancreatitis?

A

alcohol, CF due to CFTR mutation, congenital, diet

21
Q

What are the 3 pathologies leading to chronic pancreatitis?

A

duct obstruction - gallstone
sphincter of oddi function abnormal
genetic polymorphisms

22
Q

Describe the pathology of chronic pancreatitis

A

glandular atrophy and fibrous replacement
ducts strictured and calcified secretions
exposed nerves and portal hypertension

23
Q

Symptoms of chronic pancreatitis

A

abdominal pain, vomiting, weight loss, diabetes due to endocrine in-sufficiency, steathorrea

24
Q

What investigations for chronic pancreatitis and explain what used for

A

AXR - calcification of pancreas
US - size, cysts, ducts, tumours
EUS, CT, blood for amylase, albumin, LFT

25
Q

Pain management of chronic pancreatitis

A

alcohol avoidance, pancreatic enzyme supplements, celiac plexus block, endoscopy, surgery

26
Q

Exocrine and endocrine management of chronic pancreatitis

A

low fat diet, pancreatic enzyme supplements, control diabetes

27
Q

prognosis for CP?

A

better if alcohol is stopped

usually if they die its from complications

28
Q

Epidemiology of pancreatic cancer

A

males, 60-80 yrs, 11/1000000 pa

29
Q

What are 75% of pancreatic cancers?

A

duct cell mucinous adenocarcinoma

30
Q

What part of the pancreas are most tumours?

A

head

31
Q

clinical features of pancreatic cancer

A

abdominal pain, weight loss, jaundice, ascites, steathorrea

32
Q

Physical signs of pancreatic ca.

A

hepatomegaly, splenomegaly, jaundice, supraclavicular lymphadenopathy, palpable gallbladder, tender mass

33
Q

Imaging for cancer

A

USS, CT, MRI, EUS

34
Q

Investigations for cancer?

A

ERCP with a stent if jaundice and mass

biopsy by needle aspiration

35
Q

Management for cancer

A

stent, pancreatoduodenectomy, palliate jaundice, chemotherapy and pain control

36
Q

prognosis for pancreatic cancer?

A

bad

<1% 5YS most die in 6 months although if operable 15% 5YS

Year 2 GI (JK) (39 decks)

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