Pancreas

Question 1

Glasgow (IMRIE) score?

Answer 1

P – Pao2 <8kPa (arterial sample)
A – Age >55
N – Neutrophilia (WCC >15x109/L)
C – Calcium <2mmol/L
R – Renal function (urea >16mmol/L)
E – Enzymes (LDH >600iu/L, AST > 200iu/L)
A – Albumin (32g/L)
S – Sugar (blood glucose >10mmol/L)

(Predicts severity of acute pancreatitis. If score>3= Severe disease)

Question 2

Ranson’s Criteria?

Answer 2

-At admission:
Age >55 
White blood cell count > 16x109/L 
Blood glucose > 11.1 mmol/L (200 mg/dL) 
LDH >350 U/L 
AST >250 U/L

-48 hours:
Hematocrit Fall by ≥10 percent 
Blood urea nitrogen Increase by ≥5 mg/dL (1.8 mmol/L) despite fluids 
Serum calcium <8 mg/dL (2 mmol/L)
 pO2 <60 mmHg
 Base deficit >4 MEq/L 
Fluid sequestation >6000 mL

Question 3

What is Courvoisier’s Law?

Answer 3

A palpable Gallbladder in a jaundiced patient is unlikely to be due to Gallstones. More likely to be a cancer.

Question 4

Causes of acute pancreatitis?

Answer 4

I- Idiopathic

G- Gall stones
E- Ethanol
T- Trauma

S- Steroids 
M- Mumps 
A- Autoimmune 
S- Scorpion sting 
H- Hypercalcemia/ hypertriglyceridemia 
E- ERCP 
D- Drugs (Thiazides)