Pancreatitis Flashcards
What are the common lab findings for pancreatitis?
Elevated lipase, amylase,
What signs can a patient present with for acute pancreatitis?
Tea colored urine and white stools
What lab finding is associated with autoimmune pancreatitis?
IgG4 hypergammaglobulinemia
Pigmented stone is the common bile duct is associated with what disease
CD
What are the three criteria for dx of acute pancreatitis?
Need at least 2 of the 3
- Epigastric pain
- Lipase, more accurate (and amylase) 3x ULN
- CT changes consistent with pancreatitis
what is Saponification
Interaction of cations with FFAs released by the action of activated lipase’s on triglycerides in fat cells-> low blood calcium
what are the risk factors for acute pancreatitis
smoking, high dietary glycemic index, abdominal adiposity, increased age and obesity
what are some protective factors against acute pancreatitis
Eating vegetables, statins
Greater than what apache score correlates to high mortality in acute pancreatitis
> than 8
What are the Ranson criteria at admission?
“GA-LAW”
- glucose >200
- age >55
- LDH>350
- AST>250
- WBC>16,000
What are the Ranson criteria 48 hours after admission?
“C & HOBBS”
- Calcium <8
- Hematocrit drop >10%
- Oxygen (PaO2) <60mm Hg
- Base deficit >4
- BUN increase >5
- Sequestration of fluid >6L
What can be seen on XRAY that is indicative of acute pancreatitis?
“sentinel loop” that can be seen in the LUQ that is an air-filled segment.
What is the “colon cutoff sign”
Gas filled segment of transverse colon abruptly ending at the area of pancreatic inflammation.
What are some complications of SAP?
- 3rd spacing
- Pseudocysts
- ARDS
What can be seen on CT that raises clinical suspicion of pancreatic cancer?
Tumefactive chronic pancreatitis.
*painless jaundice and direct hyperbillirubinema
Besides amylase and lipas, what is a marker of pancreatic function
Fecal elastase->low in chronic pancreatitis
Trypsinogen -> low in insufficiency-> steatorrhea
What are the etiologies of chronic pancreatitis?
TIGAR-O
- Toxic metabolite- ETOH
- Idiopathic
- Genetic-CFTR, PST1, PRSS1
- Autoimmune-hyper IgG4
- Recurrent- acute pancreatitis
- Obstructive
What is associated with MEN 1
pituitary adenoma, parathyroid hyperplasia, pancreatic tumors
What is associated with MEN 2A
parathyroid hyperplasia, medullary thyroid carcinoma (elevated calcitonin), pheochromocytoma
What is associated with MEN 2B
mucosal neuromas, marafanoid body habitus, medullary thyroid carcinoma, pheochromocytoma
What is a insulinoma and what is it associated with
hyper secretion of insulin-> hypoglycemia
associated with MEN1
What is a Gastrinoma and what is it associated with
hyper secretion of gastrin-> leads to multiple ulcers
associated with MEN 1
Duodenum> pancreas
