Panc- Acute And Chronic

Question 1

Exocrine pancreatic enzymes 3 for what

Answer 1

Amylase- CHO
Trypsin- protein
Lipase- fats

Question 2

3 main causes of pancreatitis

3 small

Answer 2

Bilirubin gallstone, alcohol, hydrochlorithiazide,

Corticosteroid and contraceptive, peptic ulcer

Question 3

Mild acute vs severe (5) pancreatitis? Pc

Answer 3

Mild- nml 6 weeks hypovolemic shock

Severe acute- damage locl blood vessels, hypoxia, shock renal failure, pulmonary insufficiency, GI bleed

Question 4

Acute pancreatitis s/s

6

Answer 4

Grey tuners and Cullen's
Hypotension 
Hi-BG
Tachycardia temp 
Pain midepigastic
Tetany

Question 5

Main complication of acute pancreatitis

Answer 5

Pneumonia- (pulmonary insufficiency

Question 6

Diagnostic for pancreatic disease

Labs for how long why
Incr-6
Decrease-3

Answer 6

Elevated- s. Amylase (12 hours-4days) lipase (s&u) (2 weeks) WBC, Bilirubin, BG, BUN/creatinine

Decrease- H/H (unexpected call MD) , CA, K,

Question 7

Management of acute pancreatitis

Meds for acid(4), rest gut, infection, IV(2), to treat pc (4) pain (3)

Answer 7

NPO may have NG or enteral
Iv- TPN - lots of dextrose
Meds- hydrochloride- cimetadine,rantinide, lansoprozole, protonix,

Antispasmodic- probanthine and anticholinergic
Pain- morphine, dilaudid, fentanyl. NO demerol. Calcium gluconAte (tetany)
Hemorrhage- plasma or whole blood
Antibiotic- neomycin and kanamycin (peritonitis)
Insulin high BG
LEFT FETAL or hi fowlersposition

Question 8

Chronic pancreatitis usually cause from

Answer 8

Etoh abuse

Question 9

Clinical manifestation of chronic pancreatitis 4

Answer 9

Steatorrhea
Depression
dM type 2
Severe pain in abdmon trunk not relieve by vomit

Question 10

Diagnostic for chronic pancreatitis 4

Answer 10

ERCP-gold standard
CT cyst
Glucose intolerance pp >200 FG>126 (2 hours after meal)

Serum amaylase and WBC (if no abscess) will not be as elevated

Question 11

Non surgical management chronic 6

Pain /diet replacement / steatorrhea/ disease

Answer 11

Endoscopy (remove cyst)
Diet- low fat, low protein, high CHO, no coffee no smoking no spicy or rich foods
Pancreatic enzymes (malabsorption and steatorrhea with meals) - donnazyme and pancrealipase
Treat DM c insulin or hypoglyc- no etoh
Cimetadine- (steatorrhea) - inactivate lipase
Non narcotic if you can

Question 12

Surgical management of chronic pancreatitis 2

Answer 12

Pancreaticojejunostomy- join pancreatitis duct to jejunum- 6mo pain relief 85%

Whipple resection - pancr-duodectomy- head resection

Question 13

Kinds of questions ask if exam for pancreatitis? 5

Answer 13

Allergies 
Diarrhea- look like 
Hurt around back 
See for gallstones 
Feel warm (temp)

Question 14

Find on exam pancreatitis (general)

Answer 14

Jaundice 
Board like rigid (peritonitis) 
Ileus 
Cullen or turned
Vs- decrease bp increase HR