Pancreatic Lecture Flashcards
What are the 2 functions of the pancreas
Exocrine function
Endocrine function
What do the islet cells produce
Hormones
What do a islet cells produce
Glucagon
What do B islet cells produce
Insulin
Define acute pancreatitis
Acute inflammation process of the pancreas, with variable involvemnet of other regional tissues or remote organ systems
Define mild acute pancreatitis
It is associated with minimal organ dysfunction and an uneventful recovery
Predominant feature is interstitial oedema of the gland
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
What are 3 obstructive factors for pancreatitis
Biliary disease
Benign pancreatic duct stricture
Tumours of the ampulla or pancreas
What are 2 main toxic factors
Alcohol Viral infection (mumps)
What are the 2 metabolic factors of pancreatitis
Hyperparathyroidism
Hyperlipiproteinaemia
What does GETSMASHED stand for
Gall stones Ethanol Trauma Steroid Mumps Autoimmune Spider Bites Hyperparathyroidism ERCP Drugs
What are common findings on examination
Tenderness, peritonism, distention, bowel sounds, skin markings
What blood tests should be carried out for pancreatitis
FBC Clotting U&E LFT Amylase CRP Glucose Ca
What imaging is carried out to diagnose pancreatitis
CXR/ AXR, AUS
CT pancreas
MRI
ERCP
Why does every patient with acute pancreatitis need an AUS
To rule out biliary pancreatitis
What is a complication of pancreatitis that might be seen in a CXR
Pleural Effusion
What is the most important scan of pancreatitis
CT Scan
Allows to assess severity and follow up
What are 5 complications of pancreatitis that can be seen on CT
Fluid collections Pancreatic / peripancreatic necrosis Ascites Bleeding Abscess formation
Is ERCP a diagnostic tool for pancreatitis
No - just for intervention
How many factors of the Glasgow prognostic score means acute severe pancreatitis
3
What happens to your risk of survival as the grade of pancreatitis increases from A to E
It decreases
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
What are 6 local complications
Fluid collection Pseudocysts Abscess Necrosis and infection Ascites Pleural Effusion
What are 8 systemic complications
Pulmonary failure Renal faulure Shock Sepsis Metabolic acidosis Hyperglycaemia Hypocalcaemia MODS
