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General Surgery > pancreatitis > Flashcards

pancreatitis Flashcards

1
Q

acute pancreatitis

A

rapid onset of inflammation and symptoms

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2
Q

chronic pancreatitis

A

longer-term inflammation and symptoms

progressive and permanent deterioration in pancreatic function

fibrosis

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3
Q

three key causes

A

galllstones
alcohol
post-ERCP

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4
Q

gallstone pancreatitis

A

gallstones trapped at end of biliary system (ampulla of vater) so blocking flow of bile and pancreatic juice into duodenum

reflux back into pancreas

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5
Q

why does alcohol cause pancreatitis

A

directly toxic to pancreatic cells

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6
Q

long list of pancreatitis causes

A 
Idiopathic 
Gallstones
Ethanol
Trauma
Steroids
Mumps
Autoimmune
Scorpion sting 
Hyperlipidemia 
Drugs: furosemide, thiazide diuretics, azathioprine
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7
Q

acute pancreatitis - presentation

A 
severe epigastic pain - radiating to back 
assoc vomit 
tenderness
fever
tachycardia
raised amylase
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8
Q

Ix

A 
FBC
u&es
LFT
calcium
ABG 
amylase
USS
CT
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9
Q

amylase

A

acute - raised 3x upper limit normal

chronic - may not rise due to reduced pancreatic function

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10
Q

glasgow score

A

used to assess severity of pancreatitis ]

0-1 mild
2 moderate
3+ severe

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11
Q

glasgow score: P

A

Pa02 < 8

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12
Q

glasgow score: A

A

Age >55yrs

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13
Q

glasgow score: N

A

Neutrophils: WCC>15

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14
Q

glasgow score: C

A

Calcium <2

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15
Q

glasgow score: R

A

R urea >16

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16
Q

glasgow score: E

A

Enzymes: raised liver

17
Q

glasgow score: A

A

Albumin <32

18
Q

glasgow score: S

A

Sugar: glucose >10

19
Q

Mx acute pancreatitis

A 
ABCDE
Iv fluifd
NBM
analgesia 
ERCP/cholecystecomy if gallstones
antib if infective
20
Q

acute pancreatitis: how long to recovery

A

most patients will improve within 3-7 days

21
Q

complications of acute pancreatitis

A 
necrosis 
infection 
abscess
acute peripancreatic fluid collection 
pseudocysts
chronic pancreatitis
22
Q

chronic pancreatitis most common cause

A

alcohol

23
Q

chronic pancreatitis presentation

A

similar symptoms to acute pancreatitis but less intense and longer-lasting

24
Q

chronic pancreatitis complications

A 
chronic epigastric pain 
loss exocrine function 
loss endocrine function 
damage and strictures
pseudocyst
abscess
25
Q

chronic pancreatitis Mx

A 
alcohol + smoking abstinence
analgesia 
replacement pancreatic enzymes: creon 
insulin 
ERCP w stenting 
surgery
26
Q

chronic pancreatitis Mx - surgery indications

A

severe chronic pain
obstruction
pseudocysts
abscesses

General Surgery (33 decks)

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