pancreatic disorders Flashcards
What are the findings of chronic pancreatitis on labs?
mildy elevated amylase/lipase, glycosuria, low fecal elastase
What are the findings of acute pancreatitis on AXR?
sentinal loop (dilated bowel loop near the pancreas), right colon distention near the pancreas; pleural effusion. CT may show pseudocyst
What are the ransom criteria for increased morality from pancreatitis on admission?
GA LAW: glucose >200, AST >250, LDH >350, Age >55, WBC >16,000. High mortality if 3 or more findings
What are the findings associated with increased morality from pancreatitis 48 hrs after admission?
calcium 10%, PzO2 4, fluide sequestration >6L
What is a pancreatic pseudocyst?
fluid collection arising from the pancreas made of enzyme-rich fluids in a sac of inflamed membranous tissue
How are pancreatic pseudocysts treated?
may self resolve, but percutaneous drainage is indicated if persisting beyond 6 wks or if painful/rapidly growing
What are the complications of pancreatic pseudocysts?
rupture, hemorrhage, abscess formation
What is courvoisier sign?
palpable, nontender gallbladder often seen in exocrine pancreatic cancer
What is trousseau syndrome?
migratory thrombophlebitis
What are the treatments for insulinoma?
surigcal resection, diazoxide or octreotide in non-resectable disease
how does a glucagonoma present?
may seem like refractory DM. pts may have abd pain, diarrhea, weight loss, exfoliating rash (micratory necrolytic erythema) and other sx of DM. labs show hyperglycemia and increased glucagon
What are treatments for a glucagonoma?
octreotide, IFN-alpha, chemo, embolization in metastatic disease
VIPoma: diagnostic clues
watery diarrhea with weakness. incr. serum VIP, secretory diarrhea on stool osmolality testing
What disease is likely if you see multiple insulinomas?
MEN1
