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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

What imaging technique do we use to diagnose pancreatic cancer

CT scanning

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