Pancreatitis Flashcards

1
Q

What is the definition of pancreatitis?

A

Digestive enzymes become activated in the pancreas instead of small bowel
Pancreas becomes inflamed and shows signs of fat necrosis and oedema

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2
Q

How might a patient with acute pancreatitis present?

A

Sudden onset severe abdominal pain
Nausea
Vomiting

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3
Q

What are some of the complications of acute pancreatitis?

A
Haemorrhage
Shock
Renal failure
Respiratory failure
Pseudocyst formation
Abscess formation
Hypocalcaemia 
Hyperglycaemia
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4
Q

Which digestive enzyme is responsible for fat necrosis in pancreatitis?

A

Lipases

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5
Q

Which digestive enzyme is responsible for tissue destruction and haemorrhage in pancreatitis?

A

Proteases

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6
Q

What are some of the causes of acute pancreatitis?

A
Alcohol
Gall stones
Shock
Mumps
Hyperparathyroidism
Hypothermia
Trauma
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7
Q

What are the two most common causes of acute pancreatitis?

A

Alcohol

Gall stones

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8
Q

Why would gallstones cause acute pancreatitis?

A

Blockage of pancreatic duct would cause build up of digestive enzymes in the pancreas

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9
Q

Why might a patient with acute pancreatitis become hypocalcaemic?

A

Areas of fat necrosis can bind large amounts of calcium

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10
Q

What is Grey Turner’s sign?

A

If lipolytic enzymes leak and involve the abdominal wall, they may cause a blue/grey discolouration on the flanks

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11
Q

What is a pseudocyst?

A

A cyst without epithelial lining

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12
Q

What is chronic pancreatitis?

A

Continuing inflammation with exocrine atrophy and fibrosis

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13
Q

What is the most common cause of chronic pancreatitis?

A

Chronic alcohol excess

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14
Q

What are some of the other causes of chronic pancreatitis?

A

Gall stones
Cystic fibrosis
Hyperparathyroidism

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15
Q

What are some of the symptoms of chronic pancreatitis?

A

Intermittent upper abdominal pain

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16
Q

What is the pathogenesis of chronic pancreatitis?

A

Replacement of pancreatic tissue by chronic inflammation and scar tissue
Destruction of exocrine acini and islets
Dilated pancreatic ducts filled with protein plugs which may be calcified

17
Q

Which biochemical marker in the blood may be altered in acute pancreatitis?

A

Elevated serum amylase

18
Q

What does GET SMASHED stand for?

A
Gall stones
Ethanol 
Trauma
Steroids
Mumps
Autoimmune
Scorpions/spider bites
Hypercalcamia & hyperlipidemia
ERCP
Drugs
19
Q

How is the diagnosis of acute pancreatitis made?

A
Raised serum amylase
CXR - exclude gastroduodenal perforation
Ultrasoud
ERCP
MRCP
20
Q

How is a patient with acute pancreatitis managed?

A
IV fluid replacement
Nasogastric suction
Prophylactic antibiotics  (broad spectrum)
Analgesia
Enteral nutrition