Pancreatic disease

Question 0

Causes of acute pancreatitis other than gallstones and EtOH

Answer 0

Hypercalcemia
Hypertriglyceridemia
Thiazide side effects
Viral infections
Scorpion bites

Question 1

Ranson’s criteria for acute pancreatitis

Answer 1

GA LAW:

• Glucose > 200
• Age > 55
• LDH > 350
• AST > 250
• WBC > 16000

Within 48 hours: C HOBBS:
-Ca < 8.0
-Hct decreased by > 10%
PaO2 < 60 mmHg
Base deficit > 4
BUN increased by > 5
Sequestered fluid > 6L

Question 2

Physical exam findings of acute pancreatitis

Answer 2

Severe epigastric pain radiating towards back
Flank discoloration (Grey Turner's sign)
Periumbilical discoloration (Cullen's sign)

Question 3

Diagnosis of chronic pancreatitis

Answer 3

Lipase and amylase could be normal to high
Decreased stool elastase
Pancreatic calcifications
Mild ileus on AXR and CT (chain of lakes)

Question 4

Labs and imaging for acute pancreatitis

Answer 4

Increased amylase, increased lipase
Decreased calcium
AXR: sentinel loop or colon cutoff sign

Question 5

Pulmonary finding of pancreatitis

Answer 5

Pleural effusion

Question 6

Trousseau’s sign

Answer 6

Migratory thrombophlebitis

Pancreatic cancer

Question 7

Courvoisier’s sign

Answer 7

Palpable, nontender gallbladder

Pancreatic cancer

Question 8

What tumor marker is increased in pancreatic cancer?

Answer 8

CA-19-9

Question 9

Glucagonoma triad

Answer 9

Hyperglycemia, necrotizing dermatitis (erythematous scaly plaques), weight loss

Tumor of islet cells, usually malignant