Pancreatitis

Question 1

Etiology of pancreatitis

Answer 1

70% is due to alcohol!!!!

• elevated triglycerides >1000
• Drugs

Question 2

Cholelithiasis

Answer 2

stones that are lodged in pancreatic duct –> obstruction and extravasation of enzymes into parenchyma

Question 3

Symptoms of Pancreatitis

Answer 3

Mid-epigastric pain (95%)
Severe
Moderately rapid onset (~30 min)
Progressive and constant
Radiate to back
N/V

Question 4

Exam of pancreatitis

Answer 4

APPEAR ILL –> holding abdomen and moving around
Tender epigastrium
Gray Turner Sign –> flank ecchymosis

Question 5

Labs for pancreatitis

Answer 5

Amylase --> not so much anymore
LIPASE --> more sensitive and specific
- increased WBC, glucose
- dehydration
- elevated liver enzymes
- decreased Ca, albumin, O2
- elevated CRP

Question 6

Imaging for pancreatitis

Answer 6

Abdominal CT –> 95% accuracy for detection

X-ray –> not as common –> looking for sentinel loop

Question 7

Treatment of pancreatitis

Answer 7

IV hydration
NPO –> nothing oral
Pain control –> any narcotic

Question 8

Course of pancreatitis

Answer 8

typically improves in 3-7 days –> decreased pain and lipase levels
- abscess can form when there is bacterial seeding in a necrotizing pancreatitis

Question 9

Chronic pancreatitis

Answer 9

Lipase test isn’t helpful

- chronic calcifying pancreatitis –> protein plugs and calcifications

Question 10

Treatment of chronic pancreatitis

Answer 10

enzyme therapy, reduce fat intake, MCTs

Question 11

Pancreatic Cancer

Answer 11

Usually diagnosed late with nonspecific symptoms
5 year survival is <5%
unknown cause