pancreatitis Flashcards
what questions do you ask when someone comes in
What is the diagnosis?
How sick is he?
What is the underlying cause?
definition of acute pancreatitis
an acute inflammatory process that leads to the necrosis of pancreatic parenchyma
signs of acute pancreatitis
severe abdominal pain, nausea, vomiting, diarrhoea, fever, and shock
signs of shock
high pulse
low BP
describe capillary refil time
blood flow back into hands
should be <2s
diagnostic approach
History Examination Tests: SIMPLE BLOOD TESTS - Straight forward blood tests – everyone gets when come in COMPLEX BLOOD TEST SIMPLE IMAGING CROSS SECTIONAL IMAGING - CT INVASIVE TEST
basics first = more differentials
where is anylase produced
pancreas
salivary glands
why would white cell count be raised
infection
severe inflammation
what is ALT
alanine transferase
marker of hepatocyte function
albumin test
if low - something going on
the lower it is the worse the issue is
what is ALP
alkaline phosphatase
lines sinusoids
CT with pancreatitis
Inflammation tracking to retroperitoneal spaces and umbilicus
Magnetic resonance cholangiopancreatography
look at blockage in bile ducts – consider if no obvious cause
describe ERCP
Endoscopic retrograde cholangiopancreatography
cannular all the way down
wire into bile duct through ampulla of Vater - inject dye and take X ray
scoring systems for a pancreatitis
Ranson’s – alcoholic cause
APACHE II – anaesthesia for surgery
SIRS – inflammation
