Pancreatitis

Question 1

How is acute pancreatitis defined physiologically?

Answer 1

An acute inflammatory process of the pancreas with variable involvement of other regional tissues or remote organ systems.

Question 2

What are the two main types of pancreatitis?

Answer 2

Acute pancreatitis and chronic pancreatitis.

Question 3

What are the three main diagnostic criteria for acute pancreatitis?

Answer 3

(1) Epigastric pain consistent with pancreatitis, (2) Serum amylase or lipase >3x upper limit of normal, (3) Imaging consistent with pancreatitis (CT/MRI).

Question 4

Name three obstructive causes of acute pancreatitis.

Answer 4

Gallstones, tumors, annular pancreas.

Question 5

Name two metabolic causes of acute pancreatitis.

Answer 5

Hypertriglyceridemia, hypercalcemia.

Question 6

Name two toxins that can cause acute pancreatitis.

Answer 6

Alcohol, organophosphorus insecticides.

Question 7

Name one infectious cause of pancreatitis.

Answer 7

Mumps virus.

Question 8

What procedure is associated with post-procedural pancreatitis?

Answer 8

Endoscopic retrograde cholangiopancreatography (ERCP).

Question 9

What hereditary condition can lead to pancreatitis?

Answer 9

Hereditary/familial genetic mutations.

Question 10

What is idiopathic pancreatitis?

Answer 10

Pancreatitis of unknown cause.

Question 11

What enzyme’s premature activation is central to pancreatitis?

Answer 11

Trypsin.

Question 12

How does trypsin contribute to pancreatitis?

Answer 12

It activates other pancreatic enzymes, leading to autodigestion of the pancreas.

Question 13

What is the most common symptom of acute pancreatitis?

Answer 13

Abdominal pain.

Question 14

How is acute pancreatitis pain typically described?

Answer 14

Boring, steady, and radiating to the back.

Question 15

What percentage of acute pancreatitis cases present without pain?

Answer 15

5-10%.

Question 16

What two signs indicate hemorrhagic pancreatitis?

Answer 16

Grey Turner’s sign (flank ecchymosis) and Cullen’s sign (periumbilical ecchymosis).

Question 17

Name three systemic symptoms of acute pancreatitis.

Answer 17

Fever, nausea, vomiting.

Question 18

What is the first-line imaging modality for diagnosing pancreatitis?

Answer 18

Abdominal CT scan.

Question 19

What laboratory tests are commonly elevated in pancreatitis?

Answer 19

Serum amylase and lipase.

Question 20

What is the significance of an elevated serum lipase?

Answer 20

More specific than amylase for pancreatitis.

Question 21

What additional test is done to rule out gallstone-related pancreatitis?

Answer 21

Abdominal ultrasound.

Question 22

What hematological abnormality may be seen in pancreatitis?

Answer 22

Leukocytosis.

Question 23

Name two conditions that can mimic acute pancreatitis.

Answer 23

Perforated peptic ulcer, acute cholecystitis.

Question 24

How is diabetic ketoacidosis (DKA) differentiated from acute pancreatitis?

Answer 24

DKA has metabolic acidosis and hyperglycemia without pancreatic inflammation.

Question 25

What is the first step in managing acute pancreatitis?

Answer 25

Aggressive IV fluid resuscitation.

Question 26

Why is the patient made nil per oral (NPO) initially?

Answer 26

To rest the pancreas and reduce enzyme stimulation.

Question 27

What type of pain management is used in acute pancreatitis?

Answer 27

Intravenous narcotic analgesics.

Question 28

When are antibiotics indicated in acute pancreatitis?

Answer 28

Only in cases of infected pancreatic necrosis.

Question 29

What is the role of oxygen therapy in pancreatitis?

Answer 29

Given if hypoxia is present.

Question 30

What percentage of acute pancreatitis cases are self-limiting?

Answer 30

85-90%.

Question 31

What is the average duration of a self-limited acute pancreatitis episode?

Answer 31

3-7 days.

Question 32

How is chronic pancreatitis defined?

Answer 32

A disease with irreversible pancreatic damage.

Question 33

Name two toxic causes of chronic pancreatitis.

Answer 33

Alcohol, tobacco.

Question 34

What genetic condition is associated with chronic pancreatitis?

Answer 34

Cystic fibrosis.

Question 35

What is the most common symptom of chronic pancreatitis?

Answer 35

Abdominal pain.

Question 36

Why do chronic pancreatitis patients fear eating?

Answer 36

Eating exacerbates the pain.

Question 37

What digestive symptom is common in chronic pancreatitis?

Answer 37

Steatorrhea (fatty stools).

Question 38

What endocrine disorder can result from chronic pancreatitis?

Answer 38

Diabetes mellitus.

Question 39

What imaging technique is most useful for diagnosing chronic pancreatitis?

Answer 39

CT scan.

Question 40

What is the gold standard test for chronic pancreatitis diagnosis?

Answer 40

Endoscopic retrograde cholangiopancreatography (ERCP).

Question 41

What is the cornerstone of treatment for steatorrhea?

Answer 41

Pancreatic enzyme replacement therapy.

Question 42

What is a common challenge in managing chronic pancreatitis?

Answer 42

Chronic pain control.

Question 43

What dietary modification helps in chronic pancreatitis?

Answer 43

Low-fat diet.

Question 44

What is the role of endoscopic intervention in chronic pancreatitis?

Answer 44

Used to relieve ductal obstructions.

Question 45

When is surgical intervention considered in chronic pancreatitis?

Answer 45

When there is intractable pain or complications.

Question 46

What is the Whipple procedure used for?

Answer 46

Surgical resection of part of the pancreas in severe cases.

Question 47

What is a major long-term complication of chronic pancreatitis?

Answer 47

Pancreatic cancer.

Question 48

What lifestyle changes are essential in chronic pancreatitis management?

Answer 48

Alcohol cessation and smoking cessation.

Question 49

Why is glycemic control important in chronic pancreatitis?

Answer 49

Due to the risk of diabetes mellitus.

Question 50

What is the overall goal of chronic pancreatitis management?

Answer 50

Symptom control, preventing complications, and improving quality of life.