Pancreatitis Flashcards Preview

YEAR 1: LSS 2 - ALIMENTARY > Pancreatitis > Flashcards

Flashcards in Pancreatitis Deck (12)
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1
Q

Define acute and chronic pancreatitis.

A

Acute pancreatitis - acute inflammatory process that leads to necrosis of the pancreatic parenchyma.

Chronic pancreatitis - progressive fibroinflammatory process of the pancreas that results in permanent structural damage, which leads to impairment of exocrine and endocrine function.

2
Q

Recall the causes of acute pancreatitis.

A
Gallstones
Ethanol
Trauma
Steroids
Mumps
Autoimmune 
Scorpion Venom
Hyperlipidaemia/Hypercalcaemia
ERCP
Drugs
3
Q

State some symptoms and signs of acute pancreatitis. Name the specific signs.

A
Epigastric and RUQ pain radiating to the back
Nausea
Vomiting
Diarrhoea
Fever
Shock

Abdomen tender in the epigastrium

4
Q

List some useful tests for pancreatitis

A

Blood tests:
Elevated pancreatic enzymes (amylase/lipase)
Lipase remains elevated longer and is more specific of pancreatitis but it isn’t normally measured

Radiological tests:
Chest X-ray to eliminate possibility of perforated ulcer
Abdominal X-ray - eliminate the possibility of local ileus
Ultrasound
CT - if there is any diagnostic doubt
MRCP

Invasive Tests: ERCP

Faecal elastase test when testing for chronic pancreatitis

5
Q

What would you expect the amylase and lipase levels of a patient with chronic pancreatitis to be and why?

A

Normal - due to loss of pancreatic enzyme function

6
Q

Complications of pancreatitis

A
Systemic:
Hypovolaemia (dehydration)
Hypoxia (unable to breathe deeply because of upper quadrant pain)
Hypocalcaemia
Hyperglycaemia
DIC
Multiple Organ Failure
Local:
Pancreatic necrosis 
Fluid collections - mature into pseudocysts
Splenic vein thrombosis/pseudoaneurysm
Chronic pancreatitis
7
Q

Scoring systems used for pancreatitis?

A

Ranson’s Criteria
APACHE II
SIRS

2 or more of the following: 
Temperature >38.3 or <36
Heart rate >90
Respiratory rate >20 or PCO2 <32mmHg
WBC >12000 cells/ml or <4000 cells/ml
8
Q

Treatment for acute pancreatitis

A
Fluids
Painkillers
Nutrition
Organ support
Management of complications
9
Q

What is the diagnostic approach?

A

HISTORY
EXAMINATION
TESTS:
Simple, Blood Tests, Complex Blood Tests, Simple Imaging, Cross Sectional Imaging, Invasive Test

10
Q

Risk factors for severity

A
Necrosis vs non necrosis
Organ failure
Age
Co-morbidities
Alcohol
11
Q

Features of chronic pancreatitis

A

Malabsorption - steatorrhea
Loss of 90% exocrine function
Fat soluble vitamin ADEK malabsorption

12
Q

Management of chronic pancreatitis

A

Stop alcohol and smoking
Small meals with low fat
PPI and pancreatic supplements
Analgesia