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GI System > Pancreatic disease > Flashcards

Pancreatic disease Flashcards

1
Q

Acute pancreatitis results in raised levels of which enzyme?

A

Serum amylase

>4x normal

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2
Q

What are the two main causes of acute pancreatitis?

A 
Alcohol (60-75%)
Gallstones (25-40%)
Trauma
Drugs
Metabolic
Idiopathic
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3
Q

What are some useful investigations for acute pancreatitis?

A 
Endoscopic Retrograde Cholangio-Pancreatography (ERCP)
EUS
AUS
CXR
AXR

FBC
U&E’s
LFT
Arterial Glc

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4
Q

What criteria is used to assess the severity of acute pancreatitis?

A

Glasgow Criteria

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5
Q

What score on the Glasgow criteria indicates severe pancreatitis?

A

> 3

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6
Q

What are the factors considered in the Glasgow Criteria?

A 
White cell count >15x10^9/l
Blood Glc >10mmol/l
Blood Urea >16mmol/l
AST >200iu/l
LDH >600iu/l
Serum albumin <32g/l
Serum calcium <2mmol/l
Arterial PO2 <7.5kPa
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7
Q

How may you treat pancreatic necrosis?

A

CT guided aspiration

Antibiotics and/or surgery

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8
Q

How do you manage pancreatitis?

A 
Analgesia
IV fluids
Blood transfusion
Monitor urine output via catheter
Naso-gastric tube
Oxygen
Maybe insulin
Rarely calcium
Nutrition in severe cases
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9
Q

What are some useful investigation for gallstones in pancreatitis?

A

EUS
ERCP
MRCP

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10
Q

How might you remove gallstones in pancreatitis?

A

Cholycystectomy

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11
Q

What are some possible complications of pancreatitis?

A

Abscess

Pseudocyst

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12
Q

What is the mortality rate for mild pancreatitis?

A

<2%

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13
Q

What is the mortality rate for severe pancreatitis?

A

15%

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14
Q

How is the pain managed in chronic pancreatitis?

A 
Avoid alcohol
Pancreatic enzyme supplements
Opiate analgesia
Coeliac plexus block
Endoscopic treatment for stones and strictures
Low fat diet
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15
Q

What are some causes of acute pancreatitis?

A

GETSMASHED

Gallstones
Ethanol
Trauma
Steroids
Mumps/malignancy
Autoimmune
Scorpion sting
Hypertriglycerides/hyperglycaemia
ERCP
Drugs
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16
Q

What is the Kausch-Whipple surgery used for?

A

Most often performed to remove cancerous tumours of the head of the pancreas

17
Q

Could acute pancreatitis cause dehydration and circulatory failure?

A

Yes

18
Q

Why is lipase a better indicator for acute pancreatitis in late presenting or extremely severe cases?

A

Longer half life than amylase

Amylase levels will rise within hours but go back down within 3-5 days

GI System (20 decks)

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