Pancreatitis Flashcards
what is the most common cause of acute pancreatitis?
biliary tract disease
a patient presents with abrupt onset of epigastric abdominal pain that is steady, boring, severe, and radiating to back or sides. Pain worsens by walking and laying supine but is improved by sitting and leaning forward. Dx?
acute pancreatitis
a patient presents with fever, tachycardia, hypotension, panniculitis, cullen sign and grey turner sign. Dx?
acute pancreatitis
what will labs show that is sufficient enough to diagnose acute pancreatitis?
elevated serum amylase and lipase 3x the upper limit
serum ALT > 150 would suggest what etiology?
biliary etiology
serum TRG > 1000 would suggest what etiology?
hypertriglyceridemia etiology
elevated alkaline phosphatase would suggest what etiology?
common bile duct obstruction
what labs are indicative of severe acute pancreatitis? (2)
elevated c-reactive protein OR hypocalcemia
what is the preferred imaging for acute pancreatitis?
CT scan w/ contrast
what imaging has a higher sensitivity for diagnosing EARLY acute pancreatitis?
MRI
inflamed pancreas that releases activated pancreatic enzymes into the circulation that leads to intravascular leakage and volume depletion / hypotension. is known as a complication of acute pancreatitis.
systemic inflammatory response syndrome (SIRS)
what is the management for mild acute pancreatitis? (6)
NPO
IV fluids
nasogastric suction
opiates
bed rest
clear liquids when pain free and normal bowels
what can be done after a patient with mild acute pancreatitis has been managed of their acute episode? (2)
cholecystectomy
biliary sphincterotomy
what is the treatment for severe acute pancreatitis, with SIRS? (4)
IV fluids
whole blood + albumin
IV imipenem + cefuroxime
necrotic tissue debridement
what is the most common cause of chronic pancreatitis?
alcohol use disorder
how does chronic pancreatitis lead to diabetes mellitus in most patients?
d/t endocrine and exocrine insufficiency
a patient presents with persistent/recurrent epigastric and LUQ pain, anorexia, N/V, constipation, flatulence, weight loss. on physical exam, they have MEG tenderness. Dx?
chronic pancreatitis
what is a symptom of chronic pancreatitis that shows up late in the course?
steatorrhea
what will labs look like in chronic pancreatitis? (4)
elevated amylase + lipase
excess fecal fat
+/- elevated alk phos
+/- elevated bilirubin
what is the 1st line diagnostic for chronic pancreatitis?
MRCP
what is the treatment for chronic pancreatitis? (3)
pain: NSAIDs, acetaminophen, tramadol
pancreatic supplements before, during, and after meals
+/- prednisone (autoimmune pancreatitis)
what patient education is important for a patient with chronic pancreatitis? (3)
no alcohol
low protein diet
avoid opioid use
