Flashcards in 73. Acute pancreatitis Deck (18):
autodigestion of pancreas by pancreatic enzymes ( premature activation of trypsin)
causes of acute pancreatitis
mnemonic : I GET SMASHED and RUpture of posterio
Hypercalcemia, Hypertriglyceridemia ( >1000 mg /dL)
Drugs ( sulfa, NRTIs, portease inhibitors )
acute pancreatitis - diagnosis
2 of 3 criteria
1. acute gastric pain ( often radiating to the back )
2. high serum amylase or lipase ( more specific ) to 3x upper limit of normal
3. characteristic imaging findings
acute pancreatitis - complication
3. hemorrhage --> shock
4. infection ( or abscess)
5. organ failure ( ARDS, shock, renal failure)
6. hypocalcemia ( precipitation of Ca2+ soaps )
pancreatic pseudocyst- formed by/ findings
- formed by lined by granulation tissue, not epthelium, and pancreatic enzymes
- abdominal mass with persistently elevated serum amylase
pancreatic pseudocyst risk for
rupture--> enzymes in the abnominal cavity and hemorrhage
pancreatic abscess - due to, presents with
due to E. Coli
presents with abdominal pain, high fever, persistently elevated amylase
special clinical presentation in necrotic pancreatitis
periublical ( Cullen;s sign) and flank ( Grey turner ) hemorrhage
• Define the pathophysiology of acute pancreatitis.
Pancreatic enzymes become activated, leading to autodigestion of the pancreas
• List five causes of acute pancreatitis.
Gallstones, Ethanol, Trauma, Steroids, Mumps, Autoimmunity, Scorpions, Hypercalcemia/triglyceridemia, ERCP, Drugs (sulfa) (GET SMASHED)
• You become concerned for acute pancreatitis when an alcoholic man complains of severe abdominal pain that radiates where?
Epigastric pain that radiates to the back
• A patient has acute epigastric pain radiating to the back. What two values will be elevated, characterizing his disorder?
Amylase and lipase levels will likely be elevated (the patient has acute pancreatitis)
• Which has higher specificity for acute pancreatitis: amylase or lipase?
Lipase (amylase can be elevated in other disorders such as mumps)
• A 67-year-old woman is admitted with acute pancreatitis. For what major complications should you be vigilant?
DIC, ARDS, hypocalcemia, diffuse fat necrosis, pseudocyst formation, hemorrhage, infection, multisystem organ failure
• How does acute pancreatitis lead to hypocalcemia?
Ca2+ collects in pancreatic soap deposits, causing hypocalcemia
• A man has a CT done for persistent pain after acute pancreatitis. The pathologic structures (arrows in image) are lined by what tissue type?
Granulation tissue (these are pancreatic pseudocysts)
• A man with nausea and epigastric abdominal pain radiating to the back asks about major complications from his illness. What do you tell him?
Pancreatic pseudocysts (if he has them) can rupture and hemorrhage