Flashcards in Liver, etc. 11 - Inflammation adn tumours of Pancreas Deck (85)
What are the 3 main pancreatic diseases?
Acute pancreatitisChronic pancreatitisPancreatic tumours
What are the 5 parts of the pancreas?
What do alpha islet cells release?
What do Beta islet cells release?
What do Delta islet cells release?
What do PP cels release?
What are the 2 categories of acute pancreatitis?
Mild acuteSevere acute
What is the predominant feature of mild acute pancreatitis?
interstitial oedema of the glandAssociated with minimal organ dysfunction and an uneventful recovery
What is severe acute pancreatitis?
Associated with organ failure and/ or local complications such as necrosis (with infection), pseudocyst or abscess
What viral infections can cause acute pancreatitis?
MumpsCoxsackie B (can cause hand foot and mouth disease)Viral hepatitis
What other factor can cause acute pancreatitis apart from GET SMASHED?
What genetic factors can cause acute pancreatitis?
Cationic trypsinogen gene CF gene
What drugs can cause pancreatitis? (4)
What autoimmune disease can cause pancreatitis?
IgG4-related autoimmune disease
What causes necrosis of the pancreas during pancreatitis?
Inflammation of the parenchyma causing hypoperfusion
How is acute pancreatitis diagnosed?
History (e.g. gallstones, alcohol, drugs, trauma, infection, ERCP)ExaminationBlood testsImaging
What is peritonism?
having the clinical signs of shock and peritonitis
Possible examination findings for acute pancreatitis? (5)
TendernessPeritonismDistensionBowel soundsSkin markings
Blood tests performed to look for acute percents?
Imaging for acute pancreatitis? (5)
Findings on AXR suggestive of possible AP? (2)
Pleural effusionSentinel loop
What is a sentinel loop?
dilatation of a segment of small intestine
What is the purpose of carrying out an US for AP?
To rule out biliary pancreatitisLook for:GallstonesCholecystitisCBD diameterFree fluid
What is the purpose of carrying out a CT scan for acute pancreatitis?
Assess severity of pancreatitisDecide on interventions and follow upLook for complications (e.g. fluid collection, necrosis, ascites, bleeding, abscess)
Use of ERCP in AP?
Not as a diagnostic tool!Used for treatment of CBD stones with obstruction cholangitis as an emergency procedureUsed for treatment of acute biliary pancreatitis (if no index cholecystectomy possible)
What is the glasgow prognostic score?
PaO2 less than 8kPaAge greater than 55 yearsNeutrophils greater than 15 X 10^9/LCalcium less than 2mmol/LRenal function: urea greater than 16mmol/LEnzymes (AST/ ALT greater than 200 or LDH greater than 600)Albumin less than 32 g/LSugar (glucose less than 10 mol/L)*any 3 factors means acute severe pancreatitis
What Glasgow prognostic score = acute severe pancreatitis?
Apart form the Glasgow prognostic score, what is another scoring system that can be used to acute pancreatitis?
Ranson score (only for alcohol-induced pancreatitis)Balthazar score - used to assess percentage of necrosis and severity score from a CT scan (CT severity index)
Symptoms of acute pancreatitis? (7)
Epigastric/ diffuse abdominal pain +/- radiation to the backNausea and vomitingIndigesitonAbdominal tendernessLoss of appetite +/- weight lossTemperatureJaundice (pain)