Pancreatic Disorders Flashcards
stimulates the release of bicarbonate and water
secretin
acts directly and through vagal afferents to stimulate pancreatic acinar cells to release digestive proenzymes.
CCK
Common cause of acute pancreatitis in men and women
women-gallstones. men-alcohol
Clinical manifestations include: persistent, severe epigastric pain
or RUQ pain may be steady or colicky
N & V. band like radiation of pain to back
acute pancreatitis
Patient may have dyspnea, tachycardia, fever, ecchymotic discoloration observed in periumbilical region or along plank, shock/coma
acute pancreatitis
Lab tests that should be ordered to assess pancreatitis
serum amylase, lipase, CRP
most important test for diagnosis acute pancreatitis & intraabdominal complications and assessment of severity; ideally should have oral contrast and IV contrast
CT scan
Progressive inflammatory changes result in permanent structural damage to the pancreas, leading to impairment of exocrine & endocrine function
chronic pancreatitis
Most common cause of chronic pancreatitis
alcohol abuse
Treatment of acute pancreatitis without complications
hospitalize, fluids, NPO, bedrest
Clinical manifestations include: chronic abdominal pain, pancreatic insufficiency, fat malabsorption, pancreatic DM
chronic pancreatitis
Why are amylase and lipase usually normal in chronic pancreatitis?
because pancreas fibrotic resulting in decreased abundance of these enzymes within the pancreas
Imaging may show calcifications, ductal dilation, enlargement of pancrease, pseudocysts
chronic pancreatitis
Pharm treatment for chronic pancreatitis
NSAIDs, amitriptyine, opiates
Dietary recommendations for chronic pancreatitis
no ETOH/smoking, small low fat meals w/pancreatic enzyme supplements and H2 blockers or PPIs
Surgical treatment for chronic pancreatitis if medical and dietary therapy has failed
decompression of main pancreatic duct/psuedocyst, resection of part of the pancreas, denervation procedures
Classic manifestation of pancreatic cancer
painless jaundice w/weight loss
What is the L. supraclavicular node also called?
Virchow’s node
Survival rate for stage IV pancreatic cancer
50% have limited survival of 3-6 months
Imaging: US/CT shows pancreatic mass, dilated bile ducts, liver mets
Pancreatic cancer
Tumor marker for pancreatic cancer that can be used to assess response to treatment
CA 19.9
