pancreatitis Flashcards
two main causes of pancreatitis?
gallstones and alcohol
neumonic for causes?
Galltones
Ethanol
Trauma
Steroids Mumps Autoimmune eg. SLE Scorpion bites (rare) Hypercalcaemia, hypothermia,hyperlipidaemia Ercp Drugs
what causes discolouration of the skin (grey turners sign)
released lipase cause fat necrosis within abdomen and subcutaneous tissue, which causes discolouration of the skin
clinical features?
upper abdominal pain, normally beginning in epigastrium. accompanied by nausea and vomiting. In severe cases, they may have tachycardia, hypotension and be oliguric
what is cullens sign?
periumbilical bruising
where would you see grey turners sign?
flank
what will blood test show in pancreatitis?
raised amylase raised lipase (causing grey turners sign)
what could you pick up in urine?
raised urine amylase
what scoring system can be used to assess the severity and prognosis of pancreatitis ?
glasgow scoring scale
which levels are more specific? lipase or amylase?
lipase, but they may not be raised until 8 hours after onset of symptoms
treatment of pancreatitis?
replace lost fluids (IV)
nasogastric suction to prevent abdominal distension and vomitus and hence decrease risk of aspiration pneumonia
what is given to reduce infection complications?
prophylactic antibiotics
what accounts for most cases of chronic p?
alcohol
non specific diagnostic marker?
amylase
why do you get hypocalcaemia?
the released fatty acids from increased lipase action bind to calcium and cause hypocalcaemia