Pancreatitis Flashcards
What scoring system predicts pancreatitis?
Ranson
If clinical setting points to pancreatitis what image should be used?
None
What clinical data can be used to assess pancreatitis severity?
SIRS at admit that persists 48hrs
Pancreatitis TXT
Symptomatic and supportive Aggressive Resus fluids Pain/nausea - (IV) opioids/antimetics NPO ABX only is readily ID source
If clinical setting is still in doubt what can be performed next? Gallstone consideration
CT w/ Contrast
pancreatitis w/ respiratory complaints perform what?
CXR
How many diagnostic criteria is req? List?
2/3
- Clinical setting
- Amylase/lipase elevation (2x-3x)
- Imaging findings - CT/MRI/US
Other uncommon causes of pancreatitis?
ERCP
Rx
HyperTriGly
pancreatitis RFs
Middle aged black that smokes and is Obese w/DM
Cullen sign is?
Bluish
Umbilical
Hemoperitoneum
pancreatitis is worse when?
PO intake or laying supine
pancreatitis resus fluid protocol?
2.5-4L IVF w/ 1/3 w/in 12-24hrs
pancreatitis is better whem?
Sitting up knees bent
Prolonged bowel reast causes?
Gut atrophy > bacteria translocation>INF
Erythematous skin nodules w/ pancreatitis is due to?
focal Sub-Q fat necrosis
MC cause of chronic pancreatitis?
ETOH induced (attacks like acute but subtle)
pancreatitis PE?
guarding w/ decreased bowel sounds. Occ. Jaundiced, pale, sweat
What are common systems for organ failure ass/w pancreatitis?
Cardiopulm
Renal
Dispo pancreatitis D/C?
Nonbiliary pancreatitis controlled w/ pain and (PO) tol w/ F/U
male w/ pancreatitis due to?
ETOH
Admitting w/ biliary pancreatitis req?
Surg consult and early cholecystectomy
Severe pancreatitis is indicated by?
> 1 local/sys comps and persistent organ failure >48hrs
Grey-turn sign is
Reddish brown
Flanks
Retroperitoneal blood or pancreatic exudate
Admit pancreatitis Dispo?
1st ever acute pancreatitis any biliary associated pancreatitis req freq (IV) pain Rx Not tolerating (PO) due to pain/vomit Persistent ABNL vitals Organ failure S/S
pancreatitis vitals are? (Ass/w pain)
Tachycardic
Tachypnea
Fever
HOTN
Chemo RX - IMPACCT
Ifosfamide Mercaptopurine Pegaspargase Asparaginase-L Cisplatin/Cytarabine Tamoxifen
Rare pancreatitis late findings?
Severe necrotizing pancreatitis
Cullens sign
Grey-turner sign
Erythematous skin nodules
pancreatitis pain is located
Epigastric occ. LUQ/RUQ and radiates to back, chest, flanks
CT findings for pancreatitis?
Inflammation
Necrosis
Fluid collection
Pseudocysts
Acute pancreatitis S/S?
Severe/persistent abd pain
N/V (decreased PO intake)
Anorexia
Other ABD edema, sweat, hematesis and SOB
Rx causing pancreatitis
APAP
Antiterovirals
Chemo
Immunosupressants (Azathioprine)
Moderately pancreatitis is indicated by?
Transient organ failure <48hrs, w/ local or sys complications
Most cases of pancreatitis are?
Mild and self limiting
W/ pancreatitis if gallstones have not been excluded yet what should you do?
TransABD U/S
Other pancreatitis labs?
RFT, LFT, BMP, CBC
Admit w/ Cholangitis or known biliary obstruct req?
ERCP
female w/ pancreatitis due to?
G. Stones.
Fatal pancreatitis due to a RX?
2-3 dideoxyinosine
Does pancreatitis require NG intubation?
NO
