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Flashcards in Pancreatic Disease Deck (28):
1

What is acute pancreatitis?

Inflammation of the pancreas

2

What are the causes of acute pancreatitis?

Alcohol abuse
Gallstones
Idiopathic
Trauma
Drugs (steroids, diuretics, azathioprine)

3

What are the symptoms of acute pancreatitis?

Upper abdominal pain
Jaundice
Sudden onset
Grey Turner's/ Cullen's signs

4

What are the clinical signs of acute pancreatitis?

Elevated serum amylase levels

5

What are the investigations used to diagnose acute pancreatitis?

Bloods
AXR and CXR
Abdominal ultrasound
CT

6

How is the severity of acute pancreatitis accessed?

Glasgow criteria, score above 3 is considered severe

7

What is the general management strategy for acute pancreatitis?

Analgesia
Oxygen
Naso gastric tube
IV fluids
Blood transfusion
Monitor urine output
May need insulin

8

What is the management of acute pancreatitis caused by pancreatic necrosis?

CT guided aspiration followed by antibiotics and surgery

9

What is the management of acute pancreatitis caused by gallstones?

EUS/MRCP/ERCP
Cholecystectomy

10

What is the management of acute pancreatitis caused by abscess?

Antibiotics and drainage

11

What is a pseudocyst?

Fluid collection without an epithelial lining

12

What is the clinical sign of a pseudocyst?

Persistent hyperamylasaemia and/or pain

13

How is a pseudocyst diagnosed?

Ultrasound or CT

14

What are the complications of a pseudocyst?

Jaundice
Infection
Haemorrhage
Rupture

15

What is the treatment for a pseudocyst?

Endoscopic drainage or surgery

16

What is chronic pancreatitis?

Continuing inflammation of pancreas by irreversible glandular destruction, typically causing pain and permanent loss of function

17

What are the causes of chronic pancreatitis?

Alcohol
Cystic fibrosis
Hereditary pancreatitis
Hypercalcaemia

18

What is the pathogenesis of chronic pancreatitis?

Duct obstruction (calculi, inflammation, protein plugs)
Abnormal sphincter of Oddi function
Genetic polymorphism

19

What is the pathology of chronic pancreatitis?

Glandular atrophy and replacement by fibrous tissue
Ducts become dilated, tortuous and strictured
Inspissated secretions may calcify
Splenic, superior mesenteric and portal veins may thrombose

20

What are the clinical features of chronic pancreatitis?

Abdominal pain
Weight loss
Steatorrhoea
Jaundice
Portal hypertension
GI haemorrhage

21

What are the investigations for chronic pancreatitis?

AXR
Ultrasound
EUS
CT
Bloods
Pancreatic function tests

22

What is the management of chronic pancreatitis?

Avoid alcohol
Opiate analgesia
Coeliac plexus block
Pancreatic enzyme supplements
Surgery in selected cases

23

What is the endocrine/exocrine management of chronic pancreatitis?

Low fat diet
Pancreatic enzyme supplements
Vitamin supplements
Insulin for diabetes

24

What is the most common carcinoma of the pancreas?

Duct cell mucinous adenocarcinoma

25

What are the other less common carcinomas of the pancreas?

Carcinosarcoma
Cystadenocarcinoma
Acinar cell

26

What are the clinical features of pancreatic carcinoma?

Upper abdominal pain
Jaundice
Weight loss
Fatigue
Diarrhoea/ steatorrhoea
Ascites
Portal hypertension
Tender subcutaneous fat nodules

27

What are the physical signs of pancreatic carcinoma?

Hepatomegaly
Jaundice
Abdominal mass
Abdominal tenderness
Ascites
Splenomegaly
Supraclavicular lymphadenopathy
Palpable gallbladder

28

What is the management of pancreatic carcinoma?

Radical surgery (Whipple)
Palliation of jaundice
Pain control
Chemotherapy