Pancreas d/o Flashcards
(48 cards)
what happens at the exocrine part of the pancreas?
ducts secrete into the duodenum
what are the 2 types of pancreatic exocrine cells?
- aciner cells (95%)
- ductal epithelial cells
what do aciner cells secrete?
- proteolytic enzymes
- amylase
- lipase*
what do ductal epithelial cells secrete?
alkaline solution
what happens at the endocrine part of the pancreas?
secretion into the bloodstream
what type of cells make up the endocrine part of the pancreas?
islets of langerhan’s
(alpha, beta, delta)
what do beta cells do?
insulin secretion/synthesis
what do alpha cells do?
secrete glucagon
what do delta cells do?
secrete somatostatin (which inhibits GH and TSH)
what is pancreatitis?
inflammation that usually causes aciner cell injury
what are some causes of pancreatitis?
blockage by stone
enzymes get activated while still in pancreas
fat necrosis
basically, something makes the pancreas start to digest itself
what causes 80% of acute pancreatitis?
alcohol
gallstones
where will you feel abd pain with acute pancreatitis?
epigastric
radiates to back
describe the OPQ and T of acute pancreatitis
O: sudden
P: better with leaning forward, worse when supine
Q: colic-y
T: longer duration than GB issues
what other sx are associated with acute pancreatitis?
N/V
fever/chills
let’s talk about findings..
abdomen?
heart?
lung?
abd: tender, distention, guarding
heart: tachy
lung: dyspnea, shallow, +/- pleuritic pain
what is cullen’s sign?
periumbilical ecchymosis
seen in acute pancreatitis
what is grey-turner’s sign?
flank ecchymosis
seen in acute pancreatitis
what will you find with these labs for acute pancreatitis:
CBC
lipase
amylase
LFTs
glucose
Calcium
CBC: high WBC
lipase: high
amylase: high
LFTs: high
glucose: high
Ca: low
what is the dx test of choice for acute pancreatitis?
CT scan
what 4 things indicate a bad outcome with acute pancreatitis?
- s/s of pending organ failure
- pancreatic necrosis
- obesity
- old age
if you have a high Ranson’s criteria, what does that mean?
more severe disease and increased risk of death with acute pancreatitis
where is the APACHE-II scoring system mainly used for acute pancreatitis?
in the ICU
treatment is kinda vague but what do you do for acute pancreatitis?
NPO (NG tube) + supportive care
abx if infx
surgery if abcess/necrosis
ERCP if stone
