Pancreatic Disorders Flashcards
What lab marker is the most accurate predictor of prognosis for pancreatitis?
BUN
Acute pancreatitis is diagnosed by 2 of 3 criteria:
- Acute epigastric pain that radiates to the back
- Increased serum amylase or lipase to 3× upper limit of normal
- Characteristic imaging findings
1st and 2nd most common type of pancreatitis:
- Gallstone pancreatitis
- Alcoholic pancreatitis
Resection of the duodenum during Whipple procedure increases the risk of developing this specific nutrient deficiency:
Iron deficiency as it is solely absorbed in this part of the gastrointestinal tract
Indication of Whipple procedure:
Adenocarcinoma of the pancreas with no major vessel involvement or distal metastasis
Suggestive diagnosis of patient with obstructive jaundice and a painless, palpable gallbladder:
Pancreatic adenocarcinoma
- Acute pancreatitis first-line imaging =
- Acute pancreatitis imaging if unclear labs =
- Ultrasound*
- CT scan with IV contrast
Pancreatitis with a(n) ALT > 150 U/L is suggestive of:
Gallstone pancreatitis
What is the treatment for uncomplicated gallstone pancreatitis?
Early cholecystectomy (within 1 week)
What is the preferred initial management for symptomatic patients with a pancreatic pseudocyst (e.g. abdominal pain, vomiting)?
Endoscopic drainage
What is the likely diagnosis in a patient with a history of alcohol use and chronic, intermittent epigastric abdominal pain that is relieved by leaning forward?
Chronic pancreatitis
Chronic pancreatitis is associated with epigastric pain, alcohol abuse, fat-soluble and pancreatic insufficiency, which results in:
- Diabetes
- Malabsorption with steatorrhea
- Fat-soluble vitamin deficiencies
What is the treatment of acute pancreatitis?
- IV fluids
- Analgesia
- Early oral feeding (as soon as tolerated)
What is the preferred initial management for a minimally symptomatic patient with a small newly diagnosed pancreatic pseudocyst?
Observation and symptom management
How is a pancreatic pseudocyst diagnosed?
CT abdomen with contrast
What pancreatitis complication presents with mass effect symptoms (dyspnea, ascites, and early satiety)?
Pancreatic pseudocyst
The major risk factors for pancreatic adenocarcinoma are:
- Smoking
- Chronic pancreatitis (especially > 20 years)
Which hormone-secreting tumor is associated with dermatitis (necrolytic migratory erythema), diabetes, DVT, declining weight, depression, and diarrhea?
Glucagonoma
What is the best initial imaging modality for patients with suspected chronic pancreatitis?
Abdominal contrast-enhanced CT scan or MRCP
Symptom present in chronic pancreatitis but not in pancreatic carcinoma:
Steatorrhea
