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GI > Pancreatitis > Flashcards

Pancreatitis Flashcards

1
Q

What cranial nerve plays a role in the physiology of the pancreas?

A
  • Vagus nerve
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2
Q

What is required to stabilize trypsin in the acinar cells to prevent early activation?

A
  • steady Ca+ levels

* low intracellular Ca+ causes spontaneous trypsin activation

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3
Q

What is the most common GI cause for admission?

A
  • pancreatitis
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4
Q

Early activation of what enzyme is the most common cause of autodigestion of the pancreas?

A

Trypsin

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5
Q

What are the 2 most common causes of pancreatitis?

A
  • Gallstones

- ETOH

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6
Q

What are the 2 less common causes of pancreatitis that was highlighted in red?

A
  • hypertriglyceridemia

- trauma

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7
Q

What is the mnemonic used to remember causes of pancreatitis?

A
  • I GET SMASHED
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8
Q

Gallstone pancreatitis usually occurs in the setting of ____________.

A

choledocholithiasis

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9
Q

What is the pathophysiology of ETOH pancreatitis?

A
  • Nonoxidative ETOH metabolism in pancreases leads to fatty acid ethanol esters (FAEEs)
  • accumulation of FAEE causes activation of trypsin
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10
Q

Hypertriglyceridemia is characterized as TGs greater than _______.

A

1000 mg/dL

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11
Q

What is the treatment for hypertriglyceridemia?

A
  • High dose insulin infusion
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12
Q

How do you treat hypoglycemia d/t treatment with high dose insulin infusion for hypertriglyceridemia?

A
  • high dextrose infusion

* titrate dextrose NOT insulin

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13
Q

Which of the following pancreatic types results in the blood supply being compromised?

a. interstitial
b. necrotizing

A

b. necrotizing

* more severe process, longer duration, 5-10% of cases

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14
Q

What is the major identifying symptom of pancreatitis?

a. pain
b. nausea, vomiting
c. weakness
d. diaphoresis

A

a. pain

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15
Q

What is the difference between the following 2 unusual findings seen with pancreatitis?

cellulens and grey turners

A
  • cellulens = periumbilical ecchymosis
  • grey turners = flank ecchymosis

*usually related to hemorrhagic pancreatitis

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16
Q

What is the diagnostic criteria for pancreatitis?

A

Must have 2/3

  • abdominal pain
  • lipase >3x normal
  • imaging consistent with pancreatitis
17
Q

What are the 2 reasons lipase is the preferred for diagnosing pancreatitis?

A
  • stays elevated with ongoing damage

- amylase elevations can be seen in other processes

18
Q

What LFT finding is 95% predictive for gallstone as the cause of pancreatitis?

A
  • ALT > 3x normal
19
Q

What is the most common radiologic finding of chronic pancreatitis?

A
  • calcification within the pancreas
20
Q

What criteria is used as a bedside index of severity in acute pancreatitis?

A
  • Ranson’s criteria
21
Q

What severity of pancreatitis is this?

Local complications without organ failure that is not likely to require ICU or hospitalization

a. mild
b. moderate
c. severe

A

a. mild

22
Q

What severity of pancreatitis is this?

Transient organ failure or systemic complications. May or may not have necrosis.

a. mild
b. moderate
c. severe

A

b. moderate

23
Q

What severity of pancreatitis is this?

Persistent single or multiple organ failure. High incidence of necrosis, sterile or infected.

a. mild
b. moderate
c. severe

A

c. severe

24
Q

What are the goals (3) with fluid resuscitation in acute pancreatitis?

A
  • urine output > 0.5 cc/kg/hr
  • decreasing BUN
  • stable H/H
25
Q

What pain medication are given for pancreatitis?

A

narcotics

26
Q

What are the 3 signs of necrotic pancreatitis?

A
  • increased WBC
  • ongoing fever
  • organ failure
27
Q

T/F: There is no need to drain pseudocyts unless they are symptomatic.

A

True

28
Q

What is the pathophysiology of chronic pancreatitis?

A
  • recurrent pancreatic inflammation leads to stellate cell activation and resulting cytokine release
29
Q

What is the most common cause of chronic pancreatitis in adults vs kids?

A
  • adults = ETOH

- kids = Cystic Fibrosis

30
Q

T/F: Smoking increases the risk of chronic pancreatitis in an alcohol user.

A

True

31
Q

What are the 2 primary symptoms of chronic pancreatitis?

A
  • abdominal pain

- maldigestion/weight loss

32
Q

Autoimmune pancreatitis is usually a ____ disorder.

A

IgG4 disorder

33
Q

Autoimmune pancreatitis is responsive to what drug therapy?

A

Steroids = Prednisone

34
Q

What radiographic finding is consistent with pancreatitis?

A
  • sentinel loop

GI (6 decks)

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