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#passmed 2022 > Pancreatitis > Flashcards

Pancreatitis Flashcards

1
Q

What is pancreatitis?

A

Inflammation of pancreas

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2
Q

What are the causes of Pancreatitis? (10 things)

A
  1. G – Gallstones
  2. E – Ethanol (alcohol)
  3. T – Trauma
  4. S - Steroids
  5. M – Mumps
  6. A – AI
  7. S – Scorpion bite
  8. H – Hyperlipidaemia
  9. E – ERCP
  10. D – Drugs (furosemide, thiazide diuretics, azathioprine)
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3
Q

What are the CF of Acute Pancreatitis? (4 things)

A
  1. Epigastric pain (radiates to back)
  2. Vomiting
  3. Abd tenderness
  4. Systemically unwell (e.g low grade fever + tachycardia)
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4
Q

How is a Acute Pancreatitis diagnosis made? (2 things)

A
  1. Clinically

2. Amylase level (at least 3x upper limit of normal)

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5
Q

What investigations should be done for sus Acute Pancreatitis? (5 things)

A
  1. FBC (for WBC)
  2. U&E (for urea)
  3. LFT (for transaminases + albumin)
  4. Calcium
  5. ABG (for PaO2 + blood glucose)
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6
Q

What other investigations should be done for sus Acute Pancreatitis? (4 things)

A
  1. Amylase
  2. CRP
  3. US
  4. CT abdomen
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7
Q

What will amylase be in Acute / Chronic Pancreatitis?

A 
Acute = 3x upper limit of normal
Chronic = Maybe not raised bc reduced pancreas function
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8
Q

What is CRP used for in Acute Pancreatitis?

A

Monitor level of inflamm.

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9
Q

What is US used for in Acute Pancreatitis?

A

Assessing gallstones

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10
Q

What is a CT abdomen used for in Acute Pancreatitis?

A

Assessing complications

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11
Q

What score is used to assess the severity of Pancreatitis?

A

Glasgow Score

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12
Q

What are the criteria of the Glasgow Score? (8 things)

A
  1. P – PaO2 = less than 8
  2. A – Age = 55+
  3. N – Neutrophils = WBC 15+
  4. C – Calcium = less than 2
  5. R – uRea = 16+
  6. E – Enzymes = LDH 600+ or AST/ALT 200+
  7. A – Albumin = less than 32
  8. S = Sugar = Glucose 10+
    1 point for each answer
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13
Q

What do the Glasgow Score points correlate to in terms of severity?

A 
0-1 = mild pancreatitis
2 = moderate pancreatitis
3+ = severe pancreatitis
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14
Q

What should moderate / severe cases of Acute Pancreatitis be considered for?

A

HDU / ICU

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15
Q

What is the management for Acute Pancreatitis? (7 things)

A
  1. Resus (ABCDE)
  2. IV fluids
  3. NBM
  4. Analgesia
  5. ERCP / Cholecystectomy (if any gallstones)
  6. Abx (if specific infection evidence e.g abscess / infected necrotic area)
  7. Treat complications (e.g endoscopic / percutaneous drainage or collections)
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16
Q

How long does it take most Acute Pancreatitis patients to get better once treatment is started?

A

3-7 days

17
Q

What are the complications of Acute Pancreatitis? (6 things)

A
  1. Pancreas necrosis
  2. Infection of necrotic area
  3. Absces
  4. Acute peripancreatic fluid collections
  5. Pseudocysts (pancreatic juice collection) (dev 4 weeks after AP)
  6. Chronic pancreatitis
18
Q

What are the complications of Acute Pancreatitis that can be seen on a CT abdomen? (3 things)

A
  1. Necrosis
  2. Abscesses
  3. Fluid collection
19
Q

What are the management options for Chronic Pancreatitis? (6 things)

A
  1. X Alcohol n smoking
  2. Analgesia
  3. Replacement pancreatic enzymes (Creon) (if der is loss)
  4. Subcut insulin regimes (for any diabetes)
  5. ERCP w stenting (for strictures / obstruction to biliary system + pancreatic duct)
  6. Surgery
20
Q

What is surgery used to treat in Chronic Pancreatitis? (4 things)

A
  1. Severe chronic pain (drain ducts + remove inflamed pancreatic tissue)
  2. Obstruction of biliary system + pancreatic duct
  3. Pseudocysts
  4. Abscesses
21
Q

What can a lack of pancreatic enzymes lead to?

A

Malabsorption of fat

22
Q

What can malabsorption of fat caused by lack of pancreatic enzymes lead to? (2 things)

A
  1. Steatorrhea

2. Vit ADEK (fat soluble) deficiency

23
Q

What are the complications of Chronic Pancreatitis? (6 things)

A
  1. Chronic epigastric pain
  2. Loss of exocrine function –> lack of pancreatic enzymes sec into GIT (esp lipase)
  3. Loss of endocrine function –> lack of insulin –> diabetes
  4. Damage + strictures to duct system –> obstruction in excretion of pancreatic juice + bile
  5. Pseudocysts
  6. Abscesses
24
Q

What is the thing that shows you the progression of Chronic Pancreatitis?

A

Faecal elastase

#passmed 2022 (27 decks)

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