pancreatitis

Question 1

most common causes of acute pancreatitis

Answer 1

cholelithiasis or alcohol abusea are biggies

others include hyperlipidemia, trauma, drugs, hypercalcemia, penetrating PUD

Question 2

meds associated w/ pancreaititis

Answer 2

antiretroviral meds

Question 3

classical presentation of acute pancre

Answer 3

epigastric pain radiating to the back- lessens when the pt leans forward or lies in afetal positions

N/V common; fever, lekocytosis, steril peritonitis

Question 4

grave prognosis factros of pancreatitis

Answer 4

severe hypovolemia, ARDS, tachycardia > 130

Question 5

lab studies of pancreatitis

Answer 5

lipase more sensitive than amylase!

WBC generally elevated, liver enzymes my be increased (biliary obstruction)

bilirubin levels increased, hyperglycemia, hypocalcemia

Question 6

Ranson’s criteria

Answer 6

more sx, worse prognosis

Question 7

tx of acute pancreatisi

Answer 7

NPO!, parental hyperalimentation to restor fluids

Question 8

how do you manage pain in pancreatitis

Answer 8

meperidine

Question 9

meperidine adr

Answer 9

common: lightheadedness, dizzy, sedation, gi, sweating,, euphoria, agitiona, delerium
hypotension, all crazy shit, and cardiac sx

Question 10

chronic pancreatitis

Answer 10

90% of cases caused by alcohol abuse

cholelithiasis, PUD, hyperparathyroidism, hyperlipidemia

Question 11

classic chronic pancreatitis triad

Answer 11

panreatits calcification, steatorrhea, DM

only 20% of pts will present ths way

Question 12

clinical features of chronic pancreatitis late in the stage

Answer 12

fat malabsorption, steatorrhea, fecal fat will be elevated inf malabsroption present

Question 13

lab studies for chronic pancreatits

Answer 13

amylayse leve will decrease over time- not a useful marker

abdominal xray may reveal calcification in 20-30% of pts

Question 14

how to tx chronic pancreatitis

Answer 14

address the underlying cause (most commonly alcohol)

surgical removal may havel pain- discharge with low fat diet