Pancreatitis Flashcards

1
Q

Epidemiology of acute pancreatitis

A

3% of Acute abdomen

2-28 per 100k

mortality 12%

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2
Q

pathophysiology of Acute pancreatitis

A

activation of zymogen granules –> release proteases that digest pancrease and surrounding tissue

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3
Q

Complications of Acute pancreatitis

A

in 20%

necrosis, pseudocyst, abscess, multi-organ failure

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4
Q

Causes of acute pancreatitis

A
Idiopathic 3
Gallstones (commonest) 1
Ethanol (alchohol) 2 
Trauma
Steroids
Mumps
Autoimmune/tumour
Scorpion
Hyperlipidaemia/hypercalcaemia
ERCP (endoscopic-retrograde cholangiopancreatography) 4
Drugs (diuretics, corticosteroids, azathiprine)
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5
Q

Symptoms of acute pancreatitis

A

gradual or sudden severe epigastric/central abdominal pain radiating to the back (in65%) radiates to the back and made better if leaning forward. vomiting is common

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6
Q

Signs of acute pancreatitis

A

tachycardia

fever

jaundice

shock

paralytic ileus (quiet bowel sounds)

local/general tenderness

cullen’s/grey turner’s signs

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7
Q

Investigations in acute pancreatitis

A

Serum Amylase, serum lipase is more specific and sensitive

ABG - oxygenation and acid-base status

AXR

CXR - exclude perforation

CT - standard assessment of severity MRI better

US - pancreatic swelling or gallstones

ERCP

CRP >150 predictor of severe pancreatitis

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8
Q

How to assess severity of acute pancreatitis

A
PO2
Age
Neutrophelia
Calcium
Renal funciton
Enzymes
Abuminaemia
Sugar

3 or more within 48hrs suggests severe

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9
Q

How to manage acute pancreatitis

A

Nill by mouth - NG tube

IVI - lots of 0.9saline

aim urine flow >30ml/hr

Analgesia - pethidine or morphine

hourly obs

daily FBC, U&E, Ca, glucose, amylase, ABG

ITU if progressive

O2 if low O2

ERCP

Repeat imaging

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10
Q

What is an important blood test in pancreatitis?

A

CRP

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11
Q

what is pethidine

A

it is a synthetic morphine like opioid

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