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Gastrointestinal > Pancreatitis > Flashcards

Pancreatitis Flashcards

1
Q

What is pancreatitis?

A

Inflammation of the pancreas

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2
Q

What are the 2 forms of pancreatitis?

A

Acute and Chronic

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3
Q

What is acute pancreatitis?

A

Rapid onset of inflammation and symptoms

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4
Q

What is chronic pancreatitis?

A

Long term inflammation and symptoms

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5
Q

What is the outcome of acute pancreatitis?

A

Eventually resolves

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6
Q

What is the outcome of chronic pancreatitis?

A

Progressive and permanent

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7
Q

What are the 3 main causes of pancreatitis?

A

Gall stones
Alcohol
Post-ERCP

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8
Q

Who do gallstones tend to occur in?

A

Women and older people

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9
Q

Who tends to develop alcohol induced pancreatitis?

A

Men and younger people

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10
Q

What is the pneumonic for the other causes of pancreatitis?

A

I GET SMASHED

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11
Q

What does I GET SMASHED stand for?

A 
I- Idiopathic
G- Gallstones
E- Ethanol
T- Trauma
S- Steroids
M- Mumps
A- Autoimmune
S-Scorpion sting
H- Hyperlipidaemia
E- ERCP
D- Drugs
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12
Q

How does pancreatitis present?

A

Severe epigastric pain- radiates to back
Vomiting
Abdominal tenderness
Systemically unwell

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13
Q

Which drugs can cause pancreatitis?

A

Thiazide
Furosemide
Diuretics

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14
Q

How can the pain be relieved in someone with pancreatitis?

A

By leaning forward or lying in fetal position

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15
Q

What is the main diagnosis for Pancreatitis?

A

Lipase- more specific than amylase

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16
Q

What other investigations are carried out for pancreatitis?

A

Amylase
C-reactive protein
Ultrasound
CT abdomen

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17
Q

What will the level of amylase be in someone with Pancreatitis?

A

Three times the normal level

18
Q

What does c-reactive protein suggest?

A

Inflammation

19
Q

What would you see with an ultrasound in someone with pancreatitis?

A

Gallstones

20
Q

Why would you do a CT abdomen in someone with pancreatitis?

A

To look for complications

21
Q

How is the severity of Pancreatitis assessed?

A

Glasgow score

22
Q

What is the pneumonic for the Glasgow score?

A

PANCREAS

23
Q

What does PANCREAS stand for?

A 
P- Pa02 <60mmHg
A- Age >55
N- Neutrophilia (WBC)>15
C- Calcium <2mmol/L
R- Renal function-Urea >16mmol/L
E- Enzymes- LDH >600iU/L   AST>2000iU/L
A- Albumin <32g/L
S- Sugar- Glucose >10mmol/L
24
Q

What is the management of Acute Pancreatitis?

A

Initial resuscitation
IV fluids
Analgesia
If gallstones- ERCP or Cholecystectomy

25
Q

What are possible complications of Acute Pancreatitis?

A

Necrosis of the pancreas
Infection in a necrotic area
Abscess formation
Pseudocysts

26
Q

When do pseudocysts tend to form after pancreatitis?

A

4 weeks after

27
Q

What does chronic pancreatitis result in?

A

Fibrosis and reduced function of the pancreatic tissue

28
Q

What is the commonest cause of chronic pancreatitis?

A

Alcohol

29
Q

How long do the symptoms in chronic pancreatitis last?

A

Longer than in acute pancreatitis

30
Q

What are the main complications of chronic pancreatitis?

A

Chronic epigastric pain
Exocrine function affected
Endocrine function affected
Damage and strictures in the duct system

31
Q

How is the endocrine function affected in chronic pancreatitis?

A

Lack of insulin leading to diabetes

32
Q

How is the exocrine function affected in chronic pancreatitis?

A

Lack of pancreatic enzymes into GI tract

33
Q

What does damage and strictures lead to due to chronic pancreatitis?

A

Obstruction

34
Q

What is the lifestyle management of chronic pancreatitis?

A

Abstinence from alcohol and smoking

35
Q

What is the medical management of chronic pancreatitis?

A

Pain- Analgesia
Replacement of pancreatic enzymes
Diabetes- Subcutaneous insulin
Obstruction- ERCP with stenting

36
Q

What in the history might indicate acute pancreatitis?

A

Recent alcohol binge or gallstones

37
Q

What can be seen on examination that is highly indicative of pancreatitis?

A

Cullen’s sign

38
Q

What is cullen’s sign?

A

Bruising around the peri-umbilical area which again is highly associated with pancreatitis.

39
Q

When is the Glasgow score calculated in someone presenting with pancreaitis?

A

On admission and after 48 hours of admission

40
Q

What would a Glasgow score of more than 3 suggest?

A

A score of 3 or more positive factors indicates transfer to ITU/HDU for intensive monitoring and aggressive fluid resuscitation

41
Q

What needs to be monitored annually in someone with chronic pancreatitis?

A

HbA1c

Gastrointestinal (65 decks)

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