Pancreatitis

Question 1

use ERCP in

Answer 1

acute pancreatitis

Question 2

drains common bile duct

Answer 2

T tube

Question 3

report drainage of a T tube of greater than

Answer 3

500 mL/day

Question 4

T tube

Answer 4

anticipate 300-500 mL of thick, blood tinged, brigh yellow to dark green bile drainainge the first 24 hours after surgery

Question 5

digestive enzymes produced by pancreas

Answer 5

amylase, protease (protein), lipase (fat), bicarb

Question 6

enzymes travel via pancreatic duct to the

Answer 6

duodenum

Question 7

endocrine glands produced by the pancreas

Answer 7

insulin, glucagon, somatostatin (inhibits the secretion of other pancreatic hormones such as insulin and glucagon.), pancreatic peptide

Question 8

if exocrine glands are released into system?

Answer 8

start to digest other parts of the body or the pancrease itself

Question 9

when pancreas malfunctions

Answer 9

diarrhea, bloating, flatulence, steatorrhea, weight loss, malnutrition, poor BS control/DM

Question 10

sudden onset, lasts for several hours to several days, resolves

Answer 10

acute pancreatitis

Question 11

often undetected until symptomatic and 90 percent of cell function lost. causes scarring and inflammation

Answer 11

chronic pancreatits

Question 12

acute pancreatits patho

Answer 12

blockage of ducts, digestive enzymes become activated while still in the pancreas, repeated instances may lead to chronic

Question 13

causes of acute pancreatitis

Answer 13

gallstones, ETOH, trauma, steroids, mumps, autoimmune, snake bite, hyperlipidemia, drugs

Question 14

know meds for acute

Answer 14

see slide page 7

Question 15

S/S acute pancreatitis

Answer 15

pain, vomiting, fever, abdomen, labs, pain in back around L2

Question 16

cullins sign

Answer 16

red around bell

Question 17

turners sign

Answer 17

red at side and flank

Question 18

spell ERCP

Answer 18

endoscopic retrograde cholangiopancreatography

Question 19

labs you see in acute pancreatitis

Answer 19

WBC raised, glucose raised, LDH and AST raised, low calcium, increase BUN,

Question 20

what is the most serious complication of acute pancreatitis

Answer 20

pancreatic abscess (if rupture infection and enzymes explode)

Question 21

antispasmotic for acute pancreatitis

Answer 21

dicyclomine

Question 22

NPO for acute because?

Answer 22

mouth starts digestion

Question 23

meds for acute pancreatitis

Answer 23

opioids - morphine, hydromophone, fentanyl. antibiotics - imipenem, cefuroxime

Question 24

assessment of chronic pancreatitis

Answer 24

recurrent abdominal pain/tenderness, anorexia, N/V, weight loss, steatorrhea, S/S of DM

Question 25

ERCP is not done in

Answer 25

chronic pancreatits. can make symptoms worse

Question 26

complications of chronic pancreatitis

Answer 26

malabsorption, malnutrition, peptic ulcer disease, pancreatic abcess, stricture of common bile duct, DM, pancreatic cancer

Question 27

what is the most definitive diagnostic for pancreatic cancer

Answer 27

ERCP

Question 28

asymptomatic until later stage and often present with DVT or PE

Answer 28

pancreatic cancer

Question 29

non surgical management of pancreatic cancer

Answer 29

high doses of opioids, chemo (results not good), radiation

Question 30

surgical management of pancreatic cancer

Answer 30

whipple

Question 31

with whipple procedure never

Answer 31

adjust or re insert NG tube if dislodged or removed