Pancreatitis Flashcards
Two pulmonary risks with pancreatitis?
Pleural effusions from 3rd spacing and ARDS
Two possible signs from bleeding r/t necrotizing pancreatiits?
Get-Turners sign and Cullen’s sign
What is Cullen’s sign?
Peri-umbilical bruising
What is Grey-Turners sign?
Flank bruising
How can pancreatitis affect blood pressure?
Causes hypotension r/t
1. lowered albumin levels that lowers serum oncotic pressure leading to 3rd spacing
2. Myocardial depressant factor- decreases CO
3. Fluid loss 2nd to vomiting
What can inflammation of the pancreas and surrounding tissues lead to the release of?
- myocardial depressant factor
- histamine
- prostaglandin
- Kallikrein > bradykinan > cap. permeability and
vasodilation.
How is decreased CO from MDF release treated? (4 medications)
- steroids
- prostaglandins
- captopril
- imidazole
What can cause ALI/ARDS in pancreatitis?
- Inc. capillary permeability
- pro-inflammatory substances released from damaged cells (prostaglandin and histamine
What causes atelectasis in pancreatitis?
- Splinting from pain with breathing
- decreased movement, bedrest
- abdominal distention
- decreased mechanical inspiration volumes
How do pleural effusions develop in pancreatitis?
- 3rd spacing due to lowered albumin levels lead to lowered oncotic pressure
- Increased capillary permeability r/t histamine and prostaglandin release
- propensity to develop on the left side
What metric can be used to measure mortality in acute pancreatitis patients?
Ranson’s criteria based on 48 hour labs and/or APACHEII score
Describe pancreatic abscess formation in acute pancreatitis?
What is the primary cause and time frame for development?
- Usually develops 4 weeks after acute attack
- caused by translocation of intestinal bacteria
What is a pancreatic pseudocyst?
A fibrin encapsulation of necrotic tissue, fluid, blood and debris that usually self=resolves
How are clotting factors affected by acute pancreatitis?
- Decreased, specifically VIII and fibrinogen
What are some affects of low albumin levels in pancreatitis?
- lowered Ca+ levels
a. can lead to QT prolongation
b. muscle weakness/tremors - lowered serum oncotic pressure
a. leads to 3rd spacing
How are renal functions affected in acute pancreatitis?
There may be pre-renal failure 2nd to decreased blood flow/hypotension and fluid volume deficits from 3rd spacing and vomiting.
What causes Kallikrein to be released?
Pancreatic acinar cells be autodigested by Trypsin
How does alcohol influence pancreatitis?
May cause an increase in triglycerides leading to ischemia and an increase in pancreatic O2 demands regardless of hemodynamic patterns
