Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pharmacotherapeutics > Pancreatitis (exam 3) > Flashcards

Pancreatitis (exam 3) Flashcards

(61 cards)

Start Studying
1
Q

in pancreatitis, there is a premature activation of _________________ within the pancreas leading to activation of other digestive enzymes and _________________ of the gland

A

trypsinogen to trypsin

autodigestion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

systemic inflammatory syndrome

A

shock/organ failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

when there is a release of cytokines form T cells, there is an enhance in the inflammatory response, leading to

A

damage to tissue, edema/necrosis, hemorrhage, pseudocyst, and abscess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

defining features of SIRS

A

temperature over 38.3C or under 36C
HR over 90 beats/min
RR over 20 breaths/min or PaCO2 under 32 mmHg
WBC count over 12,000 cells/mm3, under 4000 cells/mm3, or over 10% immature forms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

two categories of acute pancreatitis

A

without recognizable tissue necrosis
necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

mild acute pancreatitis

A

no organ failure or local/systemic complications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

moderately severe acute pancreatitis

A

transient organ failure and/or local/systemic complications without persistent organ failure
lasts under 48 hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

severe acute pancreatitis

A

persistent organ failure that may involve one or more organs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

acute pancreatitis etiology

A

gall stones
ethanol
trauma
steroid use
mumps, mycoplasma, coxsakiae, malignancy
autoimmune
scorpion bite
hypertriglyceridemia
ERCP
Drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

signs and symptoms of acute pancreatitis

A

abdominal pain
N/V
low grade fever
abdominal distention
pain radiating to back
tachycardia/mild hypotension
mental aberrations
jaundice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what test is most sensitive for acute pancreatitis?

A

serum lipase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

when the serum lipase value is _________________ times the normal range, they are considered positive for acute pancreatitis

A

3-10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

contrast enhanced computed tomography

A

determines the severity of the inflammatory process
estimate of risk for systemic and local complications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

magnetic resonance cholangiopancreatography

A

non invasive
delineating the bile and pancreatic ducts, gallbladder and liver better than CT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

endoscopic retrograde cholangiopancreatography

A

more invasive
used for biliary tract and pancreatic diseases
tissue sampling suspicion of malignancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

diagnostic criteria for acute pancreatits

A

two out of three of the following:
upper abdominal pain
3x or more elevation of pancreatic values in the blood
inflammation of the gland on CT scan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Ranson’s criteria

A

used to determine severity
can predict mortality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

supportive care for acute pancreatitis

A

fluid resuscitation with normal saline or lactated ringers
pain control
nutritional support

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

_____________ can be given for nausea in acute pancreatits

A

IV antiemetics (ondansetron, prochlorperazine, promethazine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Nutritional support should begin when

A

it is anticipated that oral nutrition will be held for longer than 5 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is preferred as the method for giving nutrition in severe acute pancreatitis

A

enteral feeding via nasogastric or nasojejunal tube

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what are given for pain control in acute pancreatitis?

A

opioids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

________________ fell out of favor as the opioid of choice for pain control in acute pancreatitis because

A

mepiridine

neuromuscular side effects and seizures from accumulation of metabolite normeperidine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

are prophylactic antibiotics recommended in patients with acute pancreatitis?

A

no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
patients with known or suspected infected acute pancreatitis should receive
broad spectrum antibiotics
26
mild pancreatitis treatment
initiate oral food when pain is decreasing and lab values improve
27
moderate pancreatitis treatment
assess need for ICU admission treat systemic complications gradually advance oral diet
28
severe pancreatitis treatment
ICU admission required treat systemic complications enteral tube feeding
29
when there is no improvement in severe pancreatitis after treatment,
rule out infected pancreatic necrosis or an extra pancreatic infection and treat with antibiotics if infected
30
when a patient comes in with acute pancreatitis, what should be done?
screen for SIRS replace fluids and correct electrolytes treat metabolic abnormalities control pain assess medication as potential factors
31
consider _____________ if cholangitis or biliary pancreatitis with common bile duct obstruction
MRCP or ERCP
32
drug induced pancreatitis is classified based on
the number of cases reported time from initiation of drug to development of pancreatitis reactions with rechallenge
33
chronic pancreatitis
irreversible structural and functional loss of pancreatic function
34
chronic pancreatitis is caused by
long standing inflammation and repeated injury
35
repeated injury results in loss of
both exocrine and endocrine function
36
signs and symptoms of chronic pancreatitis
chronic abdominal pain steatorrhea weight loss/cachexia jaundice hyperglycemia
37
complications from chronic pancreatitis
diabetes pseudocysts calcification ascites biliary stricture
38
laboratory diagnosis for chronic pancreatitis
serum amylase and lipase usually normal hyperglycemia, low albumin, and hypocalcemia may be present
39
what may be elevated in ductal obstruction?
total bilirubin alkaline phosphatase hepatic transaminases
40
pancreatic function tests in chronic pancreatitis
low serum trypsinogen/trypsin (under 20 ng/ml) low fecal elastase (under 200 mcg/g) increased fecal fat estimation (over 7g/day) secretin stimulation
41
what is essential for management of chronic pancreatitis?
abstinence from alcohol
42
pain management for chronic pancreatitis
combination of nonnarcotics first ONLY narcotics if non fails
43
antiemetics for chronic pancreatitis
ondansetron, prochlorperazine, promethazine
44
the goal for nutrition is to
maximize caloric intake and weight gain and reduce steatorrhea
45
what pharmacological management can be done for chronic pancreatitis?
use of pancreatic enzyme replacement therapy
46
pancreatic enzyme replacements are
enteric coated microspheres/tablets that contain lipase, amylase and protease
47
immediate release non-EC formulation should always be administered with
an acid suppressor
48
how do microspheres work?
dissolve in a more basic pH of the duodenum act locally to break down fats, starch, protein
49
starting adult doses for pancreatic enzyme replacements are generally
30,000 to 50,000 units per meal with one half dose for snacks
50
enzymes are given
before or during a meal
51
patient may need _________________ if maximal response of enzymes is not seen
to add a PPI or H2RA
52
dosing of enzymes is based on
lipase content (units) of the product
53
adverse effects of pancreatic enzyme replacement products
nausea/abdominal cramping fibrosing colonopathy (abdominal vomiting and swelling) hyperuricosuria hyperuricemia
54
pancreatic enzyme replacement products are pregnancy category
C
55
there is a concern for what allergy when using pancreatic enzyme replacement products
pork allergy
56
patients with chronic pancreatitis may develop
type 2 diabetes mellitus
57
what is given if the patient with chronic pancreatitis develops T2DM
metformin insulin
58
metformin lowers the risk of
secondary pancreatic carcinoma
59
when there is no improvement after beginning enzyme supplement, first
decrease dietary fat to 0.5g/kg/day
60
if decreasing dietary fat does not improve chronic pancreatitis then
increase enzyme dose (max 90,000 units/meal or 10,000 units/kg/day)
61
if there is no improvement after increasing enzyme dose then,
add PPI or H2RA

Pharmacotherapeutics (28 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions