SECRETS GI - Pancreas/Appendix

Question 1

pancreatitis sx

Answer 1

epigastric pain that radiates to the back

nausea, vomiting

elevated amylase, lipase
leukocytosis
low-grade fever
hypocalcemia

Question 2

pancreatitis risk factors

Answer 2

alcohol

gallstones (acute)

Question 3

chronic pancreatitis complications

Answer 3

fat malabsorption
fat-soluble vitamin deficiency
persistent diarrhea
insulin-dependent diabetes

Question 4

appendicitis cause

Answer 4

obstruction of lumen of appendix by fecolith, lymphoid hyperplasia, tumors, stricture

Question 5

Meckel’s diverticulitis

Answer 5

asx embryologic remnant that may be lined with gastric/pancreatic tissue

gastric mucosa secretes acid –> intestinal ulcerations
pain mimics appendicitis

can also lead to intussusception, incarceration, peforation

Question 6

Meckel’s diverticulum rule of 2

Answer 6

2% population
2 inches long
2 feet from ileocecal valve

Question 7

appendix is most common site of ____

Answer 7

gut carcinoid tumor

Question 8

carcinoid tumor

Answer 8

tumor of neuroendocrine cells

secrete serotonin

Question 9

carcinoid syndrome

Answer 9

carcinoid tumor mets to liver
serotonin cannot be metabolized by liver

episodic flushing, diarrhea, wheezing, right sided heart valve lesions

Question 10

appendicitis pain

Answer 10

starts around umbilicus due to visceral pain receptors in visceral peritoneum

later parietal peritoneum is inflamed and pain localized to RLQ by somatic pain fibers

Question 11

McBurney’s point

Answer 11

2/3 distance between umbilicus and iliac crest

Question 12

appendix perforation

Answer 12

peritonitis
abdominal abscess

free air on ab xray