Pancreatitis Flashcards by Haya Al Ansari

Q

Acute pancreatitis - Pathogenesis

A

When protective mechanisms overcome inappropriate activation of enzymes within pancreas
Resulting in “auto-digestion” of pancreatic cells and inflammatory reaction (interleukins, TNF, PAF)
Acinar cells damaged and leak activated digestive enzymes into the intercellular space => fat necrosis => retroperitoneal/systemic inflammation

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Mechanisms of Acute Pancreatitis

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Epidemiology of Acute Pancreatitis

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Etiology of Acute Pancreatitis: common causes

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Etiology of Acute Pancreatitis: rare causes

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Clinical Manifestations: Local of Acute Pancreatitis

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Clinical Manifestations: Systemic of Acute Pancreatitis

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Q

Diagnosis of acute pancreatitis   (2 out of 3)

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Q

Assessment of Severity: Acute Pancreatitis

A

Ranson
Apache II
Balthazar CTSI
Glasgow-Imrie Criteria
Hong Kong Index
Atlanta
BISAP

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Q

Management of Acute Pancreatitis: Days 1-14

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Management of Acute Pancreatitis: Days 15-?

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Treatment of acute pancreatitis

A

Assessment for gallstone etiology
Abdominal sonogram (CBD > 6 mm)
ALT > 3x above normal
GGT > 7x above normal
Total bilirubin > 3.0
Cholangitis
Known gallstones (cholelithiasis)

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Q

Mechanism of Gallstone Pancreatitis

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Chronic Pancreatitis Definition

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Chronic Pancreatitis: Patterns of Pain

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Chronic Pancreatitis: Clinical Presentation

A

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Chronic Pancreatitis: Genetic

A

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Chronic Pancreatitis: Idiopathic

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Chronic Pancreatitis: Diagnosis

Laboratory Tests: Serum and Stool

A

Q

Chronic Pancreatitis: Diagnosis

Laboratory Tests: Secretin Stimulation test

A

Q

Pathophysiology of Pain in CP 
1 Mechanical – ‘Plumbing Problems’

A

Q

Pathophysiology of Pain in CP 
2 Neurobiologic – ‘wiring problems’

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Pathophysiology of Pain in CP  3 Complications

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Pathophysiology of Pain in CP  3 Complications

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Pathophysiology of Pain in CP  4 Adverse Effects of Treatment

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Opioid-induced bowel dysmotility

Bacterial overgrowth

Endoscopic complications

Surgical complications

Q

Endotherapy in Chronic Pancreatitis

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Q

Complications of Pancreatitis

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Pancreatic Fluid Collections
- Pancreatic duct disruption
- Pseudocyst
- Walled-Off Necrosis (WON)

Q

Drainage

A

Q

____ guided drainage of pseudocysts using FCSEMS is safe and effective.

A

EUS guided drainage of pseudocysts using FCSEMS is safe and effective.

Q

Drainage of PP using FCSEMS results in

A

Better clinical outcomes
Lower adverse events when compared to those drained via DP stents