Pancreas

Question 1

2 most common causes of pancreatitis?

Answer 1

1. EtOH

2. gallstones

Question 2

Other causes of acute pancreatitis?

Answer 2

1. trauma (10-50 in kids)
2. hypercalcemia (Ca++ activates enzymes)
3. HLD
4. drugs
5. scorpion stings
6. mumps
7. posterior duodenal ulcer rupture

Question 3

Lab specific for pancreatitis?

Answer 3

lipase

Question 4

Why hypocalcemia in pancreatitis?

Answer 4

fat necrosis- saponification- Ca++ used up

Question 5

What is a poor prognostic indicator in pancreatitis?

Answer 5

hypocalcemia

Question 6

Complications of pancreatitis?

Answer 6

shock, pseudocyst, abscess, DIC/ARDS

Question 7

Abd pain, high fever, high amylase, recent bout of pancreatitis?

Answer 7

pancreatic abscess (E. coli)

Question 8

What is the pathophys of chronic pancreatitis?

Answer 8

fibrosis of pancreatic parenchyma

Question 9

Most common cause of chronic pancreatitis?

Answer 9

1. EtOH

2. CF in kids

Question 10

S/s pancreatic insufficiency?

Answer 10

malabsorption, steatorrhea, fat soluble vitamin deficiencies, secondary DM, calcification around pancreas

Question 11

Risk factors pancreatic carcinoma?

Answer 11

old age, smoking, chronic pancreatitis

Question 12

Thin, elderly pt with new-onset DM2. Dx?

Answer 12

pancreatic carcinoma

Question 13

S/s pancreatic carcinoma?

Answer 13

pancreatitis, migratory thrombophlebitis, high serum CA 19-9

Question 14

What is Cullen’s sign?

Answer 14

ecchymotic discoloration in the periumbilical region- think pancreatitis

Question 15

What is Grey Turner sign?

Answer 15

ecchymotic discoloration in the flank region- think pancreatitis

Question 16

mnemonic for causes of pancreatitis?

Answer 16

I:idiopathic
G:gallstones 
E:ethanol (alcohol)
T:trauma
S:steroids
M:mumps (and other infections) / malignancy
A:autoimmune 
S:scorpion stings/spider bites
H:hyperlipidaemia/hypercalcaemia/hyperparathyroidism (metabolic disorders)
E:ERCP
D:drugs

Question 17

Normal amylase level?

Answer 17

23-85

Question 18

Normal lipase level?

Answer 18

20-300

Question 19

Normal alk phos?

Answer 19

<125

Question 20

What does a high alk phos mean?

Answer 20

liver (dz or obstruction) or bone problem

Question 21

Normal AST level?

Answer 21

15-46

Question 22

Normal ALT level?

Answer 22

9-52