pancreatitis

Question 1

gold standard imaging

Answer 1

ct with contrast

Question 2

if patient connnot take contrast what imaging

Answer 2

MRI

Question 3

dx blood test

Answer 3

lipase/ amalase 3x normal limit

Lipase is better indicator

leukocytosis

Question 4

abdominal exam findings

Answer 4

pain to palpation

possilbe guarding

Question 5

tx

Answer 5

hydration

bowel rest

pain control

Question 6

common causes of pancreatitis

Answer 6

gallstones

etoh use

trauma

Question 7

ddx

Answer 7

mi
cholangitis 
cholecyctisis 
dka
gi obstruction
hepatitis
PUD

Question 8

signs and symptoms

Answer 8

nausa and vomiting

pain worse after eating

cullens sign (belly button bruise)

grey turners sign (flank bruise)

Question 9

dx requires 2 of the 3

Answer 9

typical abdominal pain

3x elevation amylase/lipase

ct findings

Question 10

procedure

Answer 10

ERCP w/ sphincterotomy

stone removal with impacted gallstone

Question 11

complications we want to prevent

Answer 11

hemorrhagic/ necrotic pancreatitis

ards

renal failure

shock

abscess

Question 12

labs to order if elevated LFTs

Answer 12

hepatitis panel, coags, etoh, GGT

Question 13

ranson criteria dun dun dunnnnN!!!!!

at admission

Answer 13

age > than 55

WBC > 16000

blood glucose > 200

ast > 250

LDH > 350

Question 14

ranson criteria within 48 hours

Answer 14

serum calcium < 8

hematocrit fall > 10 %

oxygen paO2 < 60 mmhg

bun increased by 1.8 or more

sequestration of fluids > 6 L

base deficit > 4 meq/L

Question 15

ranson scores

Answer 15

7-8 100% mortality

5-6 40%

3-4 15%

0-2 2%