Pancreatitis Flashcards
1
Q
acute pancreatitis - treatment
A
ABCDE + call surgical reg on call initially - conservative - fluids + analgesia, place NBM + stockings NGT if vomit for asp pneum treat cause 80% improve in 3-5d
20% have a more severe attack needing:
enteral nutrition
IV abx
ICU
2
Q
what scoring system is used? what’s it based on?
A
modified glasgow
based on 8 prognostic factors identified in the first 48h
3
Q
modified glasgow scoring system - components
A
PO2 Oxygen < 60mmHg or 7.9kPa Age > 55 Neutrophilia White blood cells > 15 Calcium < 2 mmol/L Renal Urea > 16 mmol/L Enzymes Lactate dehydrogenase (LDH) > 600iu/L Aspartate transaminase (AST) > 200iu/L Albumin < 32g/L Sugar Glucose > 10 mmol/L
4
Q
what investigation is particularly useful in acute pancreatitis?
A
contrast-enhanced CT at 72h - assess degree of necrosis
CRP on admission also helpful prognostically
5
Q
acute pancreatitis - investigations
A
bedside - GOUGE
bloods (amylase, lipase, routines, calcium, haematinics (ie B12, folate)
erect CXR
USS - exclude gallstones + CT. ct if uncertain
mrcp/ercp??
