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Gastro > Pancreatic Lecture > Flashcards

Pancreatic Lecture Flashcards

1
Q

What are the 2 functions of the pancreas

A

Exocrine function

Endocrine function

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2
Q

What do the islet cells produce

A

Hormones

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3
Q

What do a islet cells produce

A

Glucagon

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4
Q

What do B islet cells produce

A

Insulin

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5
Q

Define acute pancreatitis

A

Acute inflammation process of the pancreas, with variable involvemnet of other regional tissues or remote organ systems

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6
Q

Define mild acute pancreatitis

A

It is associated with minimal organ dysfunction and an uneventful recovery
Predominant feature is interstitial oedema of the gland

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7
Q

Define severe acute pancreatitis

A

Associated with organ failure and or local complications such as necrosis, pseudocyst or abscess
Expression of the developent of pancreatic necrosis although patient with oedamatous pancreatitis may manfiest clnical features of a severe attack

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8
Q

What are 3 obstructive factors for pancreatitis

A

Biliary disease
Benign pancreatic duct stricture
Tumours of the ampulla or pancreas

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9
Q

What are 2 main toxic factors

A 
Alcohol
Viral infection (mumps)
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10
Q

What are the 2 metabolic factors of pancreatitis

A

Hyperparathyroidism

Hyperlipiproteinaemia

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11
Q

What does GETSMASHED stand for

A 
Gall stones
Ethanol
Trauma
Steroid
Mumps
Autoimmune
Spider Bites
Hyperparathyroidism
ERCP
Drugs
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12
Q

What are common findings on examination

A

Tenderness, peritonism, distention, bowel sounds, skin markings

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13
Q

What blood tests should be carried out for pancreatitis

A 
FBC
Clotting
U&E
LFT
Amylase
CRP
Glucose
Ca
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14
Q

What imaging is carried out to diagnose pancreatitis

A

CXR/ AXR, AUS
CT pancreas
MRI
ERCP

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15
Q

Why does every patient with acute pancreatitis need an AUS

A

To rule out biliary pancreatitis

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16
Q

What is a complication of pancreatitis that might be seen in a CXR

A

Pleural Effusion

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17
Q

What is the most important scan of pancreatitis

A

CT Scan

Allows to assess severity and follow up

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18
Q

What are 5 complications of pancreatitis that can be seen on CT

A 
Fluid collections
Pancreatic / peripancreatic necrosis
Ascites
Bleeding
Abscess formation
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19
Q

Is ERCP a diagnostic tool for pancreatitis

A

No - just for intervention

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20
Q

How many factors of the Glasgow prognostic score means acute severe pancreatitis

A

3

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21
Q

What happens to your risk of survival as the grade of pancreatitis increases from A to E

A

It decreases

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22
Q

What are 7 symptoms of Pancreatitis

A 
Epigastric diffuse abdominal pain radiating to the back 
Nausea and vomiting
Indigestion
Abdominal tenderness
Loss of appetite and weight loss
temperature 
jaundice
23
Q

What are 6 local complications

A 
Fluid collection 
Pseudocysts
Abscess
Necrosis and infection
Ascites
Pleural Effusion
24
Q

What are 8 systemic complications

A 
Pulmonary failure
Renal faulure
Shock
Sepsis
Metabolic acidosis
Hyperglycaemia
Hypocalcaemia
MODS
25
Q

What are the 2 most important things to do for a patient with pancreatitis

A

Give fluids and oxygen

26
Q

What will be seen on a CT straight away in necrotising pancreatitis. What do we do about this

A

Nothing

Prevent scanning too early

27
Q

What is a pseudocyst

A

A complication of AP and CP - biliary obstruction, and compresses the gastric outlet

28
Q

What do we do for a mature pseudocyts (9weeks+)

A

Drain it via surgery or ERCP

29
Q

What is a pancreatitc abscess

A

Infected fluid in and around the pancreas

30
Q

What is the modern approach of a pancreatic abscess

A

CT and US to find collection and then drain the abscess

IV antibiotics

31
Q

What are some symptoms of haemorrhage of acute pancreatitis

A

Sever pain
Low BP
Tachycardic
SEPTIC

32
Q

What does the amylase do if it is spilt into the peritoneal cavity

A

Digest everything - vessels, organs, body walls etc.

33
Q

What is chronic pancreatitis

A

Progressive and irreversible destruction of pancreatic tissue

34
Q

What does chronic pancreatitis result in?

A

Permanent loss of endocrine and exocrine function

35
Q

What is the most common reason for chronic pancreatitis

A

Alcohol abuse

36
Q

What are 2 other causes of chronic pancreatitis

A

Idiopathic

Pancreatic duct obstruction

37
Q

Where are common places to develop tropical pancreatitis

A

Indonesia, Asia

38
Q

What is the cause of autoimmune pancreatitis

A

Increased IfgG4 subclass

39
Q

What is there a high incidence of in hereditary chronic pancreatitis

A

Cancer

40
Q

What are 5 findings on examination for chronic pancreatitis

A 
Tenderness
Peritonism
Mass
Ascites
Jaundice
41
Q

What may be seen on AXR of tropical pancreatitis

A

Calcification of the pancreatic duct

42
Q

What analgesia is used in pancreatitis

A

Pacracetamol and opioids

43
Q

What are the benefits of the Pustow Procedure

A

Drains the pancreatic juice into the small bowel
Reduces pressure
Restores endocrine and exocrine function
Relieves pain

44
Q

What are 7 complications of chronic pancreatitis

A 
Splenic vein thrombosis
Pseudocyts
Pseudoaneurysms
Pancreatic Cancer
Pleural Effusion
Pancreatic ascites
Bile duct or duodenal obstruction
45
Q

How do we treat a biliary obstruction

A

Stenting
Bypass
Resect

46
Q

What are the 2 types of pancreatic cancer

A

Exocrine and Endocrine

47
Q

What are the most common types of exocrine pancreatic cancer

A

Adenocarcinoma

48
Q

What happens to the incidence rate as age increases

A

It also increases

49
Q

What are 4 symptoms of pancreatic cancer

A

Jaundice
Weight loss
Back pain or abdo pain

50
Q

What are the risk factors for pancreatic cancer

A 
SMOKING
Charred meat
Obesity 
Sendentary lifestyle
Diabetes
51
Q

How do we stage pancreatic cancer

A

TNM system

52
Q

What is the treatment for pancreatic cancer

A

Chemotherapy
Radiotherapy
Combinations
Curative or palliative

53
Q

What imaging technique do we use to diagnose pancreatic cancer

A

CT scanning

Gastro (67 decks)

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