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MS2 Exam 3 > Pancreatic Disorders > Flashcards

Pancreatic Disorders Flashcards

1
Q

Pancreas

A

normal function involves the release of pancreatic enzymes in the duodenum to assist in the digestion of proteins, starches, and fatty acids.

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2
Q

Endocrine

A

release insulin

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3
Q

Exocrine

A

-release of potent enzymes to digest fat, protein and carbs

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4
Q

lipase

A

acts on fats

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5
Q

amylase

A

acts on starches

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6
Q

inactive enzymes

A

act on protein

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7
Q

Pancreas secretes…

A

Na+ bicarb to neutralize acid

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8
Q

Acute Pancreatitis

A

inflammation that occurs when pancreatic ductal flow becomes obstructed & digestive enzymes escape from the duct and start to digest the pancreas itself.

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9
Q

Etiology of Acute Pancreatitis

A
  • biliary tract disease
  • alcoholism
  • trauma
  • viral
  • genetics
  • abscess
  • hypercalcemia
  • hypertriglyceridemia
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10
Q

Manifestations of Acute Pancreatitis

A
  • pain
  • flushing, fever, tachycardia
  • dyspnea
  • hypotension
  • jaundice
  • muscle guarding, abdominal rigidity
  • diminished or absent bowel sounds
  • Ileus, abdominal distention, ascites
  • Grey Turner’s sign
  • Cullen’s sign
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11
Q

Pseudocyst

A

A cavity outside the pancreas filled with necrotic waste and fluid. Rupture causes peritonitis.

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12
Q

ABSCESS

A

Fluid filled cavity within the pancreas associated with high fever. Requires prompt surgical intervention. Can cause sepsis with rupture.

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13
Q

Pulmonary complications of acute pancreatitis

A

Pneumonia ,atelectasis, pleural effusions

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14
Q

Nitroglycerin

A

-relaxes smooth muscles and relieves pain

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15
Q

Fluid Resuscitation

A

-IVF, albumin, plasma, volume expanders

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16
Q

Management of Acute Pancreatitis

A 
• Pain Management
• REDUCE / SUPPRESS Pancreatic
Enzymes
• MONITOR Serum Electrolytes
• MONITOR Respiratory Function
• ADMINISTER Antibiotics As Ordered
• SURGERY For Abscess, Pseudocyst Or Peritonitis
17
Q

Discharge Teaching for Acute Pancreatitis

A 
– Avoid drinking alcohol
– Avoid caffeine
– Avoid smoking
– Avoid stressful situations
– Restrict fatty foods
– Encourage carbohydrates
– Avoid crash or binge diets
– Monitor elevated blood glucose +/or fatty
stools
– Take pain medication/H2 receptor blocker
18
Q

Chronic Pancreatitis

A

progressive destruction of the pancreas with replacement of scar tissue.

19
Q

Patho of Pancreatitis

A

– Series of remissions and exacerbations

– Chronic inflammation occurs

– Irreversible damage

– Decreases digestive enzymes

– Leads to malabsorption of nutrients, fats and calories

20
Q

Manifestations of Chronic Pancreatitis

A

• INTENSE ABOMINAL PAIN
– Continuous gnawing feeling; burning; cramp-
like

  • WEIGHT LOSS with ASCITES
  • JAUNDICE
  • STEATORRHEA
  • DARK URINE
  • DIABETES

• RESPIRATORY COMPROMISE
– Adventitious / diminished breath sounds
– Dyspnea +/or orthopnea

21
Q

Goal of Chronic Pancreatitis

A
  • manage pain
  • maintain sufficient nutritional intake
  • prevent recurrence
22
Q

Pain management of Chronic Pancreatitis

A
  • analgesics
  • dilaudid most frequently used
  • frequent large doses
  • may result in dependency
  • refer to pain management team
23
Q

Enzyme Replacement

A

– Aid digestion and fat absorption

– Contain amylase,lipase & protease

– Taken before or during a meal

– Monitor consistency and number of stools daily

24
Q

Insulin Therapy

A

– Glucose checks Q2h

– May use combination of oral
hypoglycemics and insulin

25
Q

HISTAMINE RECEPTOR ANTAGONISTS

A
  • Zantac (ranitidine)
  • Decreases gastric acid
  • Enhances enzyme therapy
26
Q

DIET THERAPY

A

– Low fat, High carb, High protein,
Bland diet

– 4-6,000 calories per day

– TPN (total parenteral nutrition)

– Vitamin & mineral replacement

27
Q

Surgical Management

A

• Not primary intervention • Indicated for:
– Intractable pain
– Incapacitating pain recurrence
– Complications of pseudocycts or abscesses
• Laparoscopic Choley
• Sphincterotomy
• Distal pancreatectomy • Pancreatic transplant

28
Q

Pancreatic Cancer

A
  • 5th leading cause of death in US
  • 65 and 80
  • pancreatic head
  • prognosis is POOR
29
Q

Etiology of Pancreatic Cancer

30
Q

Regardless of the etiology of acute pancreatitis, the primary physiologic event is:

A

autodigestion

31
Q

Primary Prevention

A

– Smoking (doubles risk)

– High fat diet

– Diabetes

– Exposure to chemicals

– Chronic pancreatitis

32
Q

Manifestions of Pancreatic Cancer

A
  • pain
  • abdominal pain
  • ascites
  • anorexia
  • rapid wt loss
  • N/V
  • Jaundice
  • Clay colored stools and dark urine
33
Q

Tx for Pancreatic Cancer

A
  • usually palliative
  • surgery
  • radiation
  • chemo
34
Q

most effective tx for pancreatic

A

surgery

-Pancreaticoduodenectomy or Whipple
procedure

MS2 Exam 3 (13 decks)

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