Pancreatitis Flashcards Preview

Gastrointestinal > Pancreatitis > Flashcards

Flashcards in Pancreatitis Deck (26):
1

What are the causes of chronic pancreatitis. (7)

Alcohol (60-80%).
Rarely: familial, cyctic fibrosis, haemochromatosis, pancreatic duct obstruction (stone/tumour), raised PTH, congenital (pancreas divisum).

2

What are the symptoms of acute pancreatitis. (8)

Epigastric pain 'bores' through to the back.
Pain relieved by sitting forward or hot water bottles on epigastrium/back.
Bloating.
Steatorrhoea.
Weight loss.
Brittle diabetes.
Jaundice due to obstruction of CBD (rarely).
Symptoms relapse and worsen.

3

What is erytheme ab igne's.

Mottled dusky greyness of the skin following chronic application of hot water bottles.

4

How is chronic pancreatitis diagnosed.

Ultrasound and CT.

5

What confirms a diagnosis of chronic pancreatitis.

Pancreatic calcifications seen on ultrasound/CT.

6

What are the complications of chronic pancreatitis. (7)

Pseudocyst.
Diabetes.
Biliary obstruction.
Local arterial aneurysm.
Splenic vein thrombosis.
Gastric varices.
Pancreatic carcinoma.

7

What is chronic pancreatitis.

Continuous inflammation with irreversible structural changes to the pancreas.

8

What is seen on the blood results of a patient with chronic pancreatitis. (3)

Raised serum amylase.
Raised serum lipase.
Abnormal faecal elastase.

9

What is the differential diagnosis for patients presenting with chronic pancreatitis. (2)

Pancreatic carcinoma.
Chronic pancreatitis.

10

What are the complications of chronic pancreatitis. (4)

Pancreatic pseudocyst is the most common complication (a fluid collection surrounded by granulation tissue).
Ascites.
Pleural effusions.
Increased risk of malignancy.

11

What is involved in acute pancreatitis.

Self-perpetuating pancreatic inflammation by enzyme-mediated autodigestion.

12

What are the causes of acute pancreatitis. (13)

Gallstones.
Ethanol.
Trauma.
Steroids.
Mumps.
Autoimmune.
Scorpion venom.
Hyperlipidaemia, hypothermia, hypercalcaemia.
ECRP and emboli.
Drugs.

Also: pregnancy, neoplasia and no cause found.

13

What are the symptoms of acute pancreatitis. (4)

Gradual or sudden severe epigastric or central abdominal pain.
Pain radiates to the back.
Pain may be relieved by sitting forward.
Vomiting is prominent.

14

What are the physical signs of acute pancreatitis. (9)

May be mild or serious.
Tachycardia.
Fever.
Jaundice.
Shock.
Ileus.
Rigid abdomen.
Local or generalised tenderness.
Periumbilical bruising (Cullen's sign).
Flank bruising (Grey Turner's sign).

15

What is the cause of Cullen's and Grey Turner's signs in acute pancreatitis.

From blood vessel autodigestion and retroperitoneal haemorrhage.

16

What is seen on the blood test of a patient with acute pancreatitis. (3)

Raised serum amylase.
Raised serum lipase.
Raised CRP.

17

What conditions can cause a raised serum amylase. (5)

Pancreatitis.
Cholecystitis.
Mesenteric infarction.
GI perforation.
Renal failure.

18

What tests should be conducted in a patient with acute pancreatitis. (6)

Blood tests.
CXR.
ABG.
AXR.
US.
CT/MRI.

19

Why is a CXR conducted in a patient with acute pancreatitis.

To exclude other causes (eg perforation).

20

What is seen on the AXR of a patient with acute pancreatitis.

No psoas shadow (as there is an increase in the retroperitoneal fluid level).

21

What are the early complications of acute pancreatitis. (7)

Shock.
ARDS.
Renal failure.
DIC.
Sepsis.
Low calcium.
High glucose.

22

What are the late complications of acute pancreatitis. (7)

Pancreatic necrosis.
Pseudocysts.
Abscess.
Bleeding.
Thrombosis.
Fistulae.
Recurrent oedematous pancreatitis.

23

What percentage of acute pancreatitis cases are mild.

80%.

24

What percentage of acute pancreatitis cases develop severe/life-threatening complications.

20%.

25

What is acute pancreatitis.

It is a syndrome of inflammation of the pancreatic gland initiated by an acute injury.

26

What factors indicate a poor prognosis in acute pancreatitis. (9)

Age >55.
WCC >15.
Glucose >10.
Urea >16.
Albumin 200.
Calcium 600.
PaO2