Pancreatitis

Question 1

Acute pancreatitis - Pathogenesis

Answer 1

• When protective mechanisms overcome inappropriate activation of enzymes within pancreas
• Resulting in “auto-digestion” of pancreatic cells and inflammatory reaction (interleukins, TNF, PAF)
• Acinar cells damaged and leak activated digestive enzymes into the intercellular space => fat necrosis => retroperitoneal/systemic inflammation

Question 2

Mechanisms of Acute Pancreatitis

Answer 2

Question 3

Epidemiology of Acute Pancreatitis

Answer 3

Question 4

Etiology of Acute Pancreatitis: common causes

Answer 4

Question 5

Etiology of Acute Pancreatitis: rare causes

Answer 5

Question 6

Clinical Manifestations: Local of Acute Pancreatitis

Answer 6

Question 6

Clinical Manifestations: Systemic of Acute Pancreatitis

Answer 6

Question 7

Diagnosis of acute pancreatitis 
 (2 out of 3)

Answer 7

Question 8

Assessment of Severity: Acute Pancreatitis

Answer 8

• Ranson
• Apache II
• Balthazar CTSI
• Glasgow-Imrie Criteria
• Hong Kong Index
• Atlanta
• BISAP

Question 9

Management of Acute Pancreatitis: Days 1-14

Answer 9

Question 10

Management of Acute Pancreatitis: Days 15-?

Answer 10

Question 11

Treatment of acute pancreatitis

Answer 11

• Assessment for gallstone etiology
• Abdominal sonogram (CBD > 6 mm)
• ALT > 3x above normal
• GGT > 7x above normal
• Total bilirubin > 3.0
• Cholangitis
• Known gallstones (cholelithiasis)

Question 12

Mechanism of Gallstone Pancreatitis

Answer 12

Question 13

Chronic Pancreatitis Definition

Answer 13

Question 14

Chronic Pancreatitis: Patterns of Pain

Answer 14

Question 15

Chronic Pancreatitis: Clinical Presentation

Answer 15

Question 16

Chronic Pancreatitis: Genetic

Answer 16

Question 17

Chronic Pancreatitis: Idiopathic

Answer 17

Question 18

Chronic Pancreatitis: Diagnosis

Laboratory Tests: Serum and Stool

Answer 18

Question 19

Chronic Pancreatitis: Diagnosis

Laboratory Tests: Secretin Stimulation test

Answer 19

Question 20

Pathophysiology of Pain in CP

1 Mechanical – ‘Plumbing Problems’

Answer 20

Question 21

Pathophysiology of Pain in CP

2 Neurobiologic – ‘wiring problems’

Answer 21

Question 22

Pathophysiology of Pain in CP
 3 Complications

Answer 22

Question 23

Pathophysiology of Pain in CP
 3 Complications

Answer 23

Question 24

Pathophysiology of Pain in CP
 4 Adverse Effects of Treatment

Answer 24

Opioid-induced bowel dysmotility Bacterial overgrowth Endoscopic complications Surgical complications

Question 25

Endotherapy in Chronic Pancreatitis

Answer 25

Question 26

Complications of Pancreatitis

Answer 26

* **Pancreatic Fluid Collections** * **Pancreatic duct disruption** * **Pseudocyst** * **Walled-Off Necrosis (WON)**

Question 27

Drainage

Answer 27

Question 28

\_\_\_\_ guided drainage of pseudocysts using FCSEMS is safe and effective.

Answer 28

EUS guided drainage of pseudocysts using FCSEMS is safe and effective.

Question 29

Drainage of PP using FCSEMS results in

Answer 29

* Better clinical outcomes * Lower adverse events when compared to those drained via DP stents