Pancreatitis

Question 1

A 62 year old morbidly obese diabetic female presents with acute epigastric pain and mental confusion. She takes thiazides for hypertension. Pulse is 110 bpm with respirations of 30. She drinks alcohol occasionally. Result of ultrasound are equivocal related to the obesity. Serum triglycerides are 600 mg/dL. Amylase is 1500 U/dL (50-150) with lipase of 1200 U/L (10-140). WBC is 19,000 with elevated LDH and AST. ALT is 175 IU/L (8-32). Glucose is 350 mg/dL. BUN is 25 mg/dL with creatinine of 1.8 mg/dL. Most likely cause of pancreatitis in this patient would be:

A.CMV.

B.autoimmune.

C.lipids.

D.thiazide.

E.alcohol.

F.gallstones.

G.pancreas divisum.

H.obesity.

Question 2

What are the criteria for acute pancreatitis?

Answer 2

Need 2/3 criteria including:

1. Characteristic Abdominal pain
2. Amylase or lipase > 3 times normal
3. Characteristic findings on CT

Question 3

Central obesity is associated with what three things?

Answer 3

1. Barrets epithelium
2. adenocarcinoma of the esophagus
3. pancreatic cancer

Question 4

How does obesity make pancreatitis worse?

Answer 4

•causing local circulatory changes in peripancreatic fat and produces hypoxia by limiting respiration.

Question 5

•So BMI > 30 kg/m2 =

Answer 5

poor prognosis in pancreatitis

Question 6

What is the best test for acute pancreatitis?

Answer 6

Lipase