Pancreatic Disease Flashcards Preview

07. Year 2: Alimentary System > Pancreatic Disease > Flashcards

Flashcards in Pancreatic Disease Deck (94)
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1

What are examples of pancreatic disease?

Acute pancreatitis

Chronic pancreatitis

Pancreatic cancer

Neuroendocrine tumours

Cystic fibrosis

2

What is acute pancreatitis?

Acute inflammation of the pancreas

3

Where is the pain usually due to acute pancreatitis?

Upper abdominal pain

4

How does acute pancreatitis change serum levels of amylase?

Elevation of serum amylase (4x upper limit of normal)

5

What can acute pancreatitis be associated with in severe cases?

Multi-organ failure

6

What is the incidence of acute pancreatitis?

20-300 cases/million

7

What is the mortality of acute pancreatitis?

6-12/million

8

What is the aetiology of acute pancreatitis?

Alcohol abuse (60-75%)

Gallstones (25-40%)

Trauma (blunt/postoperative/post ERCO)

Miscellaneous (drugs, viruses, pancreatic carcinoma, metabolic, autoimmune)

Idiopathic (about 10%)

9

What are examples of drugs that can cause acute pancreatitis?

Steroids

Azathioprine

Diuretics

10

What are examples of viruses that can cause acute pancreatitis?

Mumps

Coxsackie B4

HIV

CMV

11

What are metabolic changes that can cause acute pancreatitis?

Increased calcium

Increased triaglycerides

Decreased temperature

12

Explain the pathogenesis of acute pancreatitis?

1) Primary insult

2) Release of activated pancreatic enzymes

3) Autodigestion causing pro-inflammatory cytokines, reactive oxygen species, oedema, fat necrosis and haemorrhage

13

What are the clinical features of acute pancreatitis?

Abdominal pain

Vomiting

Pyrexia

Tachycardia

Oliguria

Jaundice

Paralytic ileus

Retroperitoneal haemorrhage

Hypoxia (respiratory failure in most severe cases)

Hypocalcaemia

Hyperglycaemia (occsaionally diabetic coma)

Effusions

14

What is paralytic ileus?

Obstruction of the intestine due to paralysis of the intestinal muscles

15

What is oligouria?

Urine output less than:

1mL/kg/h in infants

0.5mL/kg/h in children

400ml or 500ml per 24 hours in adults

16

What is strange about ERCP and acute panceatitis?

ERCP is a cause and a treatment of acute pancreatitis

17

What investigations are done for acute pancreatitis?

Blood tests

Abdominal and chest x-ray

Abdominal ultrasound

CT scan (contrast enhanced)

18

What is being looked for in an abdominal ultrasound for acute pancreatitis?

Pancreatic oedema

Gallstones

Pseudocyst

19

What blood tests are done for acute pancreatitis?

Amylase

Lipase

FBC

LFTs

Calcium

Glucose

Arterial blood gases

Lipids

Coagulation screen

20

What is used to assess the severity of acute pancreatitis?

Glasgow criteria

21

Using the glasgow criteria, what is considered to be severe pancreatitis?

A score of 3 or more

22

What is the white cell count for the glasgow criteria?

>15 x 109/L

23

What is the blood glucose for the glasgow criteria?

>10mmol/L

24

What is the blood urea for the glasgow criteria?

>16mmol/L

25

What is the AST for the glasgow criteria?

>200iu/L

26

What is the LDH for the glasgow criteria?

>600iu/L

27

What is the serum albumin for the glasgow criteria?

<32g/L

28

What is the serum calcium for the glasgow criteria?

<2mmol/L

29

What is the arterial PO2 for the glasgow criteria?

<7.5kPa

30

What is assessed with the glasgow criteria?

White cell count

Blood glucose

Blood urea

AST

LDH

Serum albumin

Serum calcium

Arterial PO2