Week 3 Flashcards
signs and symptoms of acute pancreatitis
- Upper abdominal pain; worse with eating
- pain that radiates to your back,
- fever, rapid pulse,
- nausea, vomiting
- tenderness when touching the abdomen
risk factors for acute pancreatitis
- Alcoholism,
- gallstones
- abdominal surgery
- cigarette smoking,
- family history of pancreatitis,
- hypertriglyceridemia,
- injury to abdomen
- pancreatic cancer
diagnostic evaluation of pancreatitis
- Blood test for elevated levels of pancreatic enzymes
- Stool test to measure levels of fat that could suggest your digestive system isn’t absorbing nutrients adequately
- CT scan to look for gallstones and assess the extent of pancreas inflammation
- Endoscopic ultrasound to look for inflammation and blockages in the pancreatic duct or bile duct
- MRI to look for abnormalities in the gallbladder, pancreas, and ducts
role of premature activation of trypsin in pancreatitis
Trypsinogen is converted to trypsin in the pancreas which activates proenzymes which leads to destruction of pancreatic cells which leads to recruitment of proinflammatory cytokines
potential complications of acute pancreatitis
- Acute Necrotizing pancreatitis:
- Pseudocyst formation: fluid and debris collect in cyst like pockets in your pancreas. A large pseudocyst that ruptures can cause complications such as internal bleeding and infection.
- Chronic Pancreatitis
cholelithiasis vs choledocholithiasis, vs ascending cholangitis.
- Cholelithiasis: presence of gallstones in thegallbladder
- choledocholithiasis: gallstones in thecommon bile duct
- Cholangitis: infection of the biliary tract caused by obstruction of the biliary tree
diagnostic evaluation of gallstone diseases
- Liver tests
- blood’samylaseorlipaselevels to look forinflammationof thepancreas.
-(CBC): high white blood cell count may indicate infection.
-ultrasound testing:uses sound waves to image and make a picture of gallbladder. - abdominal X-ray, which may show evidence of gallbladder disease, such asgallstones.
- (CT) scan
- HIDA scan: hydroxy iminodiacetic acid (HIDA) is injected into the patien taken up by the gallbladder to measure gallbladder emptying function.
• Magnetic resonance cholangiopancreatography (MRCP)
• Endoscopic retrograde cholangiopancreatography (ERCP): tube is placed down the patient’s throat, into thestomach, then into the small intestine. Dye is injected and the ducts of the gallbladder,liver, and pancreas can be seen on X-ray.
use of IV fluid resuscitation and analgesia in the management of acute pancreatitis
- patient is kept NPO so intravenous (IV) fluid hydration is provided.
- Analgesics are administered for pain relief.
endoscopic ultrasound (EUS)
- special endoscope uses high-frequency sound waves to produce detailed images of the lining and walls of your digestive tract and chest, nearby organs such as the pancreas and liver, and lymph nodes.
- minimally invasive procedure to assess digestive (gastrointestinal) and lung diseases
Endoscopic retrograde cholangiopancreatography (ERCP)
- uses a dye to highlight the bile ducts on X-ray images. A thin, flexible tube (endoscope) with a camera on the end is passed down your throat and into your small intestine. The dye enters the ducts through a small hollow tube (catheter) passed through the endoscope.
biliary sphincterotomy
- cutting the muscle that surrounds the opening of the ducts, or the papilla to enlarge the opening.
- mall wire on a specialized catheter uses electric current to cut the tissue during the ERCP
cholecystectomy
- relieve the pain and discomfort of gallstones.
- dietary modifications, usually can’t stop gallstones from recurring, so a cholecystectomy is the only way to prevent gallstones.
risk factors of cirrhosis
- Intravenous drug abuse
- Multiple sex partners (36%)
- surgery within the last 6 month
- Needle stick injury
- Multiple contacts with an HCV-infected person (
- Employment in medical or dental fields
Shifting dullness
When ascites is present, the area of dullness will shift to the dependent site. The area of tympany will shift toward the top.
Palmar Erythema
- Warmth or burning in both hands
- causes a splotchy red color on your palms, and sometimes even your fingers.
- secondarily caused by cirrhosis
