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ER 3 > Pancreatitis > Flashcards

Pancreatitis Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

What scoring system predicts pancreatitis?

A

Ranson

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2
Q

If clinical setting points to pancreatitis what image should be used?

A

None

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3
Q

What clinical data can be used to assess pancreatitis severity?

A

SIRS at admit that persists 48hrs

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4
Q

Pancreatitis TXT

A 
Symptomatic and supportive
Aggressive Resus fluids
Pain/nausea - (IV) opioids/antimetics
NPO
ABX only is readily ID source
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5
Q

If clinical setting is still in doubt what can be performed next? Gallstone consideration

A

CT w/ Contrast

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6
Q

pancreatitis w/ respiratory complaints perform what?

A

CXR

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7
Q

How many diagnostic criteria is req? List?

A

2/3

  1. Clinical setting
  2. Amylase/lipase elevation (2x-3x)
  3. Imaging findings - CT/MRI/US
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8
Q

Other uncommon causes of pancreatitis?

A

ERCP
Rx
HyperTriGly

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9
Q

pancreatitis RFs

A

Middle aged black that smokes and is Obese w/DM

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10
Q

Cullen sign is?

A

Bluish
Umbilical
Hemoperitoneum

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11
Q

pancreatitis is worse when?

A

PO intake or laying supine

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12
Q

pancreatitis resus fluid protocol?

A

2.5-4L IVF w/ 1/3 w/in 12-24hrs

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13
Q

pancreatitis is better whem?

A

Sitting up knees bent

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14
Q

Prolonged bowel reast causes?

A

Gut atrophy > bacteria translocation>INF

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15
Q

Erythematous skin nodules w/ pancreatitis is due to?

A

focal Sub-Q fat necrosis

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16
Q

MC cause of chronic pancreatitis?

A

ETOH induced (attacks like acute but subtle)

17
Q

pancreatitis PE?

A

guarding w/ decreased bowel sounds. Occ. Jaundiced, pale, sweat

18
Q

What are common systems for organ failure ass/w pancreatitis?

A

Cardiopulm

Renal

19
Q

Dispo pancreatitis D/C?

A

Nonbiliary pancreatitis controlled w/ pain and (PO) tol w/ F/U

20
Q

male w/ pancreatitis due to?

A

ETOH

21
Q

Admitting w/ biliary pancreatitis req?

A

Surg consult and early cholecystectomy

22
Q

Severe pancreatitis is indicated by?

A

> 1 local/sys comps and persistent organ failure >48hrs

23
Q

Grey-turn sign is

A

Reddish brown
Flanks
Retroperitoneal blood or pancreatic exudate

24
Q

Admit pancreatitis Dispo?

A 
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
25
Q

pancreatitis vitals are? (Ass/w pain)

A

Tachycardic
Tachypnea
Fever
HOTN

26
Q

Chemo RX - IMPACCT

A 
Ifosfamide
Mercaptopurine
Pegaspargase
Asparaginase-L
Cisplatin/Cytarabine
Tamoxifen
27
Q

Rare pancreatitis late findings?

A

Severe necrotizing pancreatitis
Cullens sign
Grey-turner sign
Erythematous skin nodules

28
Q

pancreatitis pain is located

A

Epigastric occ. LUQ/RUQ and radiates to back, chest, flanks

29
Q

CT findings for pancreatitis?

A

Inflammation
Necrosis
Fluid collection
Pseudocysts

30
Q

Acute pancreatitis S/S?

A

Severe/persistent abd pain
N/V (decreased PO intake)
Anorexia
Other ABD edema, sweat, hematesis and SOB

31
Q

Rx causing pancreatitis

A

APAP
Antiterovirals
Chemo
Immunosupressants (Azathioprine)

32
Q

Moderately pancreatitis is indicated by?

A

Transient organ failure <48hrs, w/ local or sys complications

33
Q

Most cases of pancreatitis are?

A

Mild and self limiting

34
Q

W/ pancreatitis if gallstones have not been excluded yet what should you do?

A

TransABD U/S

35
Q

Other pancreatitis labs?

A

RFT, LFT, BMP, CBC

36
Q

Admit w/ Cholangitis or known biliary obstruct req?

A

ERCP

37
Q

female w/ pancreatitis due to?

A

G. Stones.

38
Q

Fatal pancreatitis due to a RX?

A

2-3 dideoxyinosine

39
Q

Does pancreatitis require NG intubation?

A

NO

ER 3 (6 decks)

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