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From Flashcardlet > Med Pancreas > Flashcards

Med Pancreas Flashcards

0
Q

Venous drainage

A

Portal system

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1
Q

Blood supply of pancreas

A

Celiac to gastroduodenal to sup pancreaticoduodenal

Superior mesenteric artery to inf pancreaticoduodenal

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2
Q

Lymphatic drainage of pancreas

A

Pancreaticosplenic
Pancreaticoduodenal
Preaortic lymph nodes

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3
Q

Pancreas are how many % exocrine or endocrine?

A

80% exocrine

20% endocrine

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4
Q

Unique structure of pancreas

A

Centroacinar cells

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5
Q

4 endocrine cells in the islet of langerhans and their secretions

A

A: glucagon
B: insulin
D: somatostatin
PP

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6
Q

Pain in acute pancreatitis

A

Epigastric that radiates to back

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7
Q

Increased 3x in acute pancreatitis

A

Amylase and lipase

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8
Q

2 conditions that may develop from acute pancreatitis

A

DM and steatorrhea

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9
Q

Diagnostic modality to distinguish interstitial pancreatitis from necrotizing pancreatitis

A

Contrast-enhanced pancreatitis

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10
Q

Ranson’s and Apache II scores for severe acute pancreatitis

A

Ranson’s >=3

Apache II >= 8

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11
Q

Signs of shock

A

SBP <90 mmHg
PaO2 <=60mmHg
Creatinine >2 mg/dL
GI bleeding >500ml/24h

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12
Q

When do encapsulated pseudocyst appear

A

4-6weeks after acute pancreatitis

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13
Q

T or F?

Pancreatic abscess has higher mortality than pancreatic necrosis

A

False

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14
Q

Most common cause of pancreatitis

A

Alcohol, drugs, gallstone

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15
Q

2 theories for pancreatitis

A

Trypsinogen conversion to protein (trypsinogen activation peptide)
Common channel theory

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16
Q

Tx for migraine that cause spasm of sphincter of Oddi

A

Ergotamine (overdose)

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17
Q

Tx for HCC that cause pancreatitis

A

Arterial embolization and

Atheromatous embolization to pancreas

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18
Q

Essential in penetrating trauma to pancreas

A

Laparotomy

19
Q

Lab finding not reflective of injury

A

Increase in amylase

20
Q

Used to asses pancreatic injury

A

ERCP

21
Q

Posture or position that cause pain in pancreatitis when supine

A

Knee-chest or double up posture

22
Q

Hemorrhagic signs due to fat necrosis

A

Cullen’s sign (periumbilical)

Grey turner sign (flanks)

23
Q

Not elevated in chronic pancreatitis

A

Amylase

24
Q

Suggests pancreatitis when elevated 2x or more

A

Lipase

25
Q

Specific for gallstone pancreatitis

A

ALT >150 IU/L

26
Q

6 signs that reflect severe pancreatic injury

A 
<50% hematocrit
>16,000 WBC count
Increased BUN
Metabolic ACIDOSIS
Low O2 saturation (ARDS)
Decreased Ca2+ (saponification)
27
Q

Indications for CT scan of pancreas

A

Rule out mesenteric infarction and perforations
Staging the severity
Define presence of complications

28
Q

Ranson’s criteria on admission

A 
>55 y/o
WBC >16,000
Glucose >200 mg/dl
AST >250 IU/L
LDH >350 IU/L
29
Q

Ranson’s criteria during initial 48 hours

A 
Decrease of >10 mg/dL in hematocrit
BUN increase of 5mg/dL
Ca2+ <8mg/dL
PaO2 <60mmHg
Base deficit of >4 meq/L
>6L fluid sequestration
30
Q

Ranson’s score for mild pancrwatitis

A

1.6

31
Q

Ranson’s score for severe pancreatitis

A

2.4

32
Q

Ranson’s score for lethal pancreatitis

A

5.6

33
Q

Score of <=9 in apache II

A

Survived within 48hrs

34
Q

Score of >=13 apache II

A

High mortality

35
Q

Marker that is higher in sever and necrotizing pancreatitis

Activity peaks at 36-48 hrs

A

CRP

36
Q

Assesses pancreatic severity after 48hrs

A

TAP in urine

37
Q

T or F?

High TAP, high damage

A

True

38
Q

T or F?

Obesity is an early prognostic sign

A

True

39
Q

CT and CXR results for SEVERE Pancreatitis

A

CT: pleural effusion within 72h
CXR: pleural effusion within 6d

40
Q

Eliminates sepsis but does not reduce mortality

A

ERCP

41
Q

Tx for pancreatic abscess

A

Percutaneous catheter drainage

42
Q

Tx for Pancreatic pseudocyst

A

Tx for pancreatic pseudocyst

43
Q

Tx for pancreatic necrosis

A

Percutaneous aspiration

Surgical debridement

44
Q

Mgt for severe pancreatitis

A

Fluid resuscitation: >5-6 to 10 L/day
Colloids if albumin is <2g/L (hypoalbuminemia)
Packed RBC transfusion if Hct is <25%

45
Q

Higher mortality in pancreatitis is attributed to

A

Idiopathic and postoperative pancreatitis

From Flashcardlet (33 decks)

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