pancreatitis

Question 1

causes

Answer 1

I GET SMASHED (idopathic, gallstones, ethanol, trauam, steroid use, mumps, autoimmune, scorpion sting, hyperlipidaemia/hypercalcaemia, ERCP, drugs (loop, HIV, GLP1)

Question 2

pathophysis

Answer 2

blockage -> auto digestion -> inflammation -> abdominal distension + vomiting + odema -> ileus + hypotension + tachy

severe inflammation -> DIC

jaundice

Question 3

acute pancreatitis symptoms

Answer 3

sudden onset, n/v, abdo pain

Question 4

chornic pancreatitis symptoms

Answer 4

abdo pain that radiates to back, n/v, bloating, weight loss, steatorrhea

Question 5

pancreatitis signs

Answer 5

cullens sign, grey turners syndrome

Question 6

cullens sign

Answer 6

superficla oedema + brusing around umbilical area

Question 7

grey turners syndrome

Answer 7

bruising + oedema around flanks

Question 8

investigations

Answer 8

LFT x3 amylase/lipase
cholestatic pictures (ALP/GGT>ALT/AST)

FBC = high WBC, high CRP, high HCT, anaemia

triglyceride 1000+

U+E

ultrasound/MRCP (gallstones)

CT abdo

Question 9

how to rank pancreatitis score

Answer 9

glasglow

Question 10

differential of pancreatitis

Answer 10

acute cholecystitis, acute cholangitis, gastroenteritis, AAA

Question 11

treatment of pancreatitis

Answer 11

fluid, analgesia, NG feeding, insulin

Question 12

complicaitons

Answer 12

pre-renal AKI

liquefaction necrosis of pancreas -> triglyceride release -> fibrosis -> pseudocysts -> ecoli infection - > pancreatic abscess

Destruction of the pancreatic artery -> haemorrhagic necrosis -> hypovolemic shock -> blood accumulates retro-premium -> chilens sign (bleeding around umbilical)