Flashcards in Pancreatic Lecture Deck (53):
1
What are the 2 functions of the pancreas
Exocrine function
Endocrine function
2
What do the islet cells produce
Hormones
3
What do a islet cells produce
Glucagon
4
What do B islet cells produce
Insulin
5
Define acute pancreatitis
Acute inflammation process of the pancreas, with variable involvemnet of other regional tissues or remote organ systems
6
Define mild acute pancreatitis
It is associated with minimal organ dysfunction and an uneventful recovery
Predominant feature is interstitial oedema of the gland
7
Define severe acute pancreatitis
Associated with organ failure and or local complications such as necrosis, pseudocyst or abscess
Expression of the developent of pancreatic necrosis although patient with oedamatous pancreatitis may manfiest clnical features of a severe attack
8
What are 3 obstructive factors for pancreatitis
Biliary disease
Benign pancreatic duct stricture
Tumours of the ampulla or pancreas
9
What are 2 main toxic factors
Alcohol
Viral infection (mumps)
10
What are the 2 metabolic factors of pancreatitis
Hyperparathyroidism
Hyperlipiproteinaemia
11
What does GETSMASHED stand for
Gall stones
Ethanol
Trauma
Steroid
Mumps
Autoimmune
Spider Bites
Hyperparathyroidism
ERCP
Drugs
12
What are common findings on examination
Tenderness, peritonism, distention, bowel sounds, skin markings
13
What blood tests should be carried out for pancreatitis
FBC
Clotting
U&E
LFT
Amylase
CRP
Glucose
Ca
14
What imaging is carried out to diagnose pancreatitis
CXR/ AXR, AUS
CT pancreas
MRI
ERCP
15
Why does every patient with acute pancreatitis need an AUS
To rule out biliary pancreatitis
16
What is a complication of pancreatitis that might be seen in a CXR
Pleural Effusion
17
What is the most important scan of pancreatitis
CT Scan
Allows to assess severity and follow up
18
What are 5 complications of pancreatitis that can be seen on CT
Fluid collections
Pancreatic / peripancreatic necrosis
Ascites
Bleeding
Abscess formation
19
Is ERCP a diagnostic tool for pancreatitis
No - just for intervention
20
How many factors of the Glasgow prognostic score means acute severe pancreatitis
3
21
What happens to your risk of survival as the grade of pancreatitis increases from A to E
It decreases
22
What are 7 symptoms of Pancreatitis
Epigastric diffuse abdominal pain radiating to the back
Nausea and vomiting
Indigestion
Abdominal tenderness
Loss of appetite and weight loss
temperature
jaundice
23
What are 6 local complications
Fluid collection
Pseudocysts
Abscess
Necrosis and infection
Ascites
Pleural Effusion
24
What are 8 systemic complications
Pulmonary failure
Renal faulure
Shock
Sepsis
Metabolic acidosis
Hyperglycaemia
Hypocalcaemia
MODS
25
What are the 2 most important things to do for a patient with pancreatitis
Give fluids and oxygen
26
What will be seen on a CT straight away in necrotising pancreatitis. What do we do about this
Nothing
Prevent scanning too early
27
What is a pseudocyst
A complication of AP and CP - biliary obstruction, and compresses the gastric outlet
28
What do we do for a mature pseudocyts (9weeks+)
Drain it via surgery or ERCP
29
What is a pancreatitc abscess
Infected fluid in and around the pancreas
30
What is the modern approach of a pancreatic abscess
CT and US to find collection and then drain the abscess
IV antibiotics
31
What are some symptoms of haemorrhage of acute pancreatitis
Sever pain
Low BP
Tachycardic
SEPTIC
32
What does the amylase do if it is spilt into the peritoneal cavity
Digest everything - vessels, organs, body walls etc.
33
What is chronic pancreatitis
Progressive and irreversible destruction of pancreatic tissue
34
What does chronic pancreatitis result in?
Permanent loss of endocrine and exocrine function
35
What is the most common reason for chronic pancreatitis
Alcohol abuse
36
What are 2 other causes of chronic pancreatitis
Idiopathic
Pancreatic duct obstruction
37
Where are common places to develop tropical pancreatitis
Indonesia, Asia
38
What is the cause of autoimmune pancreatitis
Increased IfgG4 subclass
39
What is there a high incidence of in hereditary chronic pancreatitis
Cancer
40
What are 5 findings on examination for chronic pancreatitis
Tenderness
Peritonism
Mass
Ascites
Jaundice
41
What may be seen on AXR of tropical pancreatitis
Calcification of the pancreatic duct
42
What analgesia is used in pancreatitis
Pacracetamol and opioids
43
What are the benefits of the Pustow Procedure
Drains the pancreatic juice into the small bowel
Reduces pressure
Restores endocrine and exocrine function
Relieves pain
44
What are 7 complications of chronic pancreatitis
Splenic vein thrombosis
Pseudocyts
Pseudoaneurysms
Pancreatic Cancer
Pleural Effusion
Pancreatic ascites
Bile duct or duodenal obstruction
45
How do we treat a biliary obstruction
Stenting
Bypass
Resect
46
What are the 2 types of pancreatic cancer
Exocrine and Endocrine
47
What are the most common types of exocrine pancreatic cancer
Adenocarcinoma
48
What happens to the incidence rate as age increases
It also increases
49
What are 4 symptoms of pancreatic cancer
Jaundice
Weight loss
Back pain or abdo pain
50
What are the risk factors for pancreatic cancer
SMOKING
Charred meat
Obesity
Sendentary lifestyle
Diabetes
51
How do we stage pancreatic cancer
TNM system
52
What is the treatment for pancreatic cancer
Chemotherapy
Radiotherapy
Combinations
Curative or palliative
53