Pancreatitis Flashcards

1
Q

What are the common lab findings for pancreatitis?

A

Elevated lipase, amylase,

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2
Q

What signs can a patient present with for acute pancreatitis?

A

Tea colored urine and white stools

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3
Q

What lab finding is associated with autoimmune pancreatitis?

A

IgG4 hypergammaglobulinemia

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4
Q

Pigmented stone is the common bile duct is associated with what disease

A

CD

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5
Q

What are the three criteria for dx of acute pancreatitis?

A

Need at least 2 of the 3

  • Epigastric pain
  • Lipase, more accurate (and amylase) 3x ULN
  • CT changes consistent with pancreatitis
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6
Q

what is Saponification

A

Interaction of cations with FFAs released by the action of activated lipase’s on triglycerides in fat cells-> low blood calcium

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7
Q

what are the risk factors for acute pancreatitis

A

smoking, high dietary glycemic index, abdominal adiposity, increased age and obesity

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8
Q

what are some protective factors against acute pancreatitis

A

Eating vegetables, statins

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9
Q

Greater than what apache score correlates to high mortality in acute pancreatitis

A

> than 8

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10
Q

What are the Ranson criteria at admission?

A

“GA-LAW”

  • glucose >200
  • age >55
  • LDH>350
  • AST>250
  • WBC>16,000
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11
Q

What are the Ranson criteria 48 hours after admission?

A

“C & HOBBS”

  • Calcium <8
  • Hematocrit drop >10%
  • Oxygen (PaO2) <60mm Hg
  • Base deficit >4
  • BUN increase >5
  • Sequestration of fluid >6L
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12
Q

What can be seen on XRAY that is indicative of acute pancreatitis?

A

“sentinel loop” that can be seen in the LUQ that is an air-filled segment.

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13
Q

What is the “colon cutoff sign”

A

Gas filled segment of transverse colon abruptly ending at the area of pancreatic inflammation.

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14
Q

What are some complications of SAP?

A
  • 3rd spacing
  • Pseudocysts
  • ARDS
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15
Q

What can be seen on CT that raises clinical suspicion of pancreatic cancer?

A

Tumefactive chronic pancreatitis.

*painless jaundice and direct hyperbillirubinema

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16
Q

Besides amylase and lipas, what is a marker of pancreatic function

A

Fecal elastase->low in chronic pancreatitis

Trypsinogen -> low in insufficiency-> steatorrhea

17
Q

What are the etiologies of chronic pancreatitis?

A

TIGAR-O

  • Toxic metabolite- ETOH
  • Idiopathic
  • Genetic-CFTR, PST1, PRSS1
  • Autoimmune-hyper IgG4
  • Recurrent- acute pancreatitis
  • Obstructive
18
Q

What is associated with MEN 1

A

pituitary adenoma, parathyroid hyperplasia, pancreatic tumors

19
Q

What is associated with MEN 2A

A

parathyroid hyperplasia, medullary thyroid carcinoma (elevated calcitonin), pheochromocytoma

20
Q

What is associated with MEN 2B

A

mucosal neuromas, marafanoid body habitus, medullary thyroid carcinoma, pheochromocytoma

21
Q

What is a insulinoma and what is it associated with

A

hyper secretion of insulin-> hypoglycemia

associated with MEN1

22
Q

What is a Gastrinoma and what is it associated with

A

hyper secretion of gastrin-> leads to multiple ulcers
associated with MEN 1

Duodenum> pancreas