Pancreatic problems

Question 1

what percentage of acute pancreatitis requires hospitalization?

Answer 1

20%

Question 2

most cases of acute pancreatitis resolve how?

Answer 2

spontaneously

Question 3

what happens with acute pancreatitis?

Answer 3

there is some obstruction of the outflow of pancreatic enzymes by way of the pancreatic and bile duct from gallstones, this build up leads to autodigestion of the pancreatic cells

Question 4

what are the common clinical manifestations of acute pancreatitis?

Answer 4

-severe, sudden epigastric pain that may radiate to the back
-tenderness and guarding
-N/V
-distended abdomen
-hypoactive BS
-fever
-grey turner’s sign
-cullen’s sign

Question 5

what labs are typically elevated with acute pancreatitis?

Answer 5

amylase, lipase, WBC

Question 6

how is glucose affected in acute pancreatitis?

Answer 6

can be high or low

Question 7

where is the discoloration in grey turner’s sign?

Answer 7

flanks

Question 8

where is the discoloration in cullen’s sign?

Answer 8

periumbilical

Question 9

what is a pseduocyst?

Answer 9

a fluid filled cavity that surrounds the outside of the pancreas

Question 10

what is the fluid that is inside of a pseduocyst?

Answer 10

necrotic products and secretions

Question 11

what is the highest concern with a pseudocyst?

Answer 11

perforation because it will cause peritonitis

Question 12

what are the clinical presentation of pseudocysts?

Answer 12

similar to pancreatitis:
- sudden, severe epigastric pain that may radiate to the back
-N/V
-tenderness and guarding
-fever
-hypotension, tachycardia, jaundice
-grey turner’s sign
-cullen’s sign

+ palpable epigastric mass

Question 13

what is an abscess related to acute pancreatitis?

Answer 13

a large fluid filled cavity inside of the pancreas

Question 14

what is the highest concern with an abscess related to acute pancreatitis?

Answer 14

further infection or perforation (which would lead to perinotitis)

Question 15

what is the clinical presentation for an abscess related to acute pancreatitis?

Answer 15

-sudden, severe epigastric pain that radiates to the back
-N/V
-hypotension, tachycardia, jaundice
-tenderness and guarding
-fever
-grey turner’s sign
-cullen’s sign

+ abdominal mass, high fever, and leukocytosis

Question 16

why might a patient with acute pancreatitis develop pleural effusion?

Answer 16

edema and increased vascular permeability

Question 17

what electrolyte disturbance is commonly seen with acute pancreatitis?

Answer 17

hypocalemia

Question 18

if there is an excessive level of trypsin built up in the system what can it cause?

Answer 18

edema, necrosis, and hemorrhage

Question 19

if there is an excessive level of elastase built up in the system what can it cause?

Answer 19

hemorrhage

Question 20

if there is an excessive level of phospholipase A built up in the system what can it cause?

Answer 20

fat necrosis

Question 21

if there is an excessive level of kallikrein built up in the system what can it cause?

Answer 21

edema, increased vascular permeability, smooth muscle contraction, shock

Question 22

if there is an excessive level of lipase built up in the system what can it cause?

Answer 22

fat necrosis

Question 23

what is chronic pancreatitis?

Answer 23

a progressive, fibrotic disease of the pancreas

Question 24

what is the most common cause of chronic pancreatitis?

Answer 24

alcohol abuse

Question 25

specifically with chronic pancreatitis and alcohol abuse what do the toxic metabolites do?

Answer 25

release inflammatory cytokines that cause destruction of the acinar cells and islet of langerhans

Question 26

what are the risk factors associated with chronic pancreatitis?

Answer 26

genetics, gallstone obstruction, smoking

Question 27

what are the two major signs of chronic pancreatitis?

Answer 27

abdominal pain and weight loss

Question 28

what condition can chronic pancreatitis lead to d/t the destruction of the islet of langerhans?

Answer 28

diabetes