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32 Cards in this Set
- Front
- Back
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90% of acute pancreatitis are caused by |
alcohol or gallstones |
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a less common cause of acute panc |
trauma |
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a screening lab value that is also associated wtih acute pancreatitis |
hypertriglyceridemia |
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an electrolyte abnormality that can lead to acute pancreatitsi |
hypercalcemia |
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some rare causes of acute pancreatitsi |
infection drug toxicity drug allergy sulfa drugs ductal obstruction
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what procedure commonly predisposes to acute pancreatitis |
ERCP |
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what insect? |
scorpion sting |
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What hereditary disease can be assoc'd with higher risk of AP? |
CF |
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what HIV medication gives a pretty high risk of acute pancreatitis? |
didanosine |
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what prophylactic HIV drug is also associated with acute panc? |
pentamidine |
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classic presentation of AP |
epigastric pain radiating back tenderness N/V |
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severe cases present with |
hypotension and fever |
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the pain of pancreatitis radiates straight through the back like a spear stabbing into the abdomen |
cholecystitis can ALSO radiate to the back but generally wraps aroudn the side |
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MI's can also present with epigastric pain radiating to the bakc |
but it's generally distributed higher up and should be in women and diabetics with atypical MI symptoms |
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What lab value conveys the WORST prognosis in acute pancreatitis? |
hypocalcemia |
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Why does hypocalcemia indicate a poor prognosis? |
because it means that calcium is bindng to fat in the bowel and soponifying |
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does a high amylase or lipase correlate with disease severity in pancreatitis? |
no it does not
neither does pain intensity |
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best initial test if you suspect pancreatitis |
amylase and lipase
but the questions don't generally ask this |
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what is the most specific test for pancreatitis? |
CT scan showing calcficiations |
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What does Ct tell you? |
it can correlate disease severity quite accurately
and it can also show a pseudocyst |
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what is the use of MRCP? |
MRCP is useful if you think that stones, strictures or tumor could be the reason for developing pancreatitis
MRCP is diagnostic |
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so what is the use of ERCP? |
it's therapeutic- it's most used for removal of stones |
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Should the CT be done with or without contrast? |
WITH- this helps you visualize the abdominal organs a lot |
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treatment for acute pancreatitis |
mostly just supportive: NPO IV hydration at high volume analgesia PPI's |
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When do we use antibiotics in acute pancreatitis>? |
antibiotics are reserved for very severe cases that show over 30% necrosis on CT/MRI
they have been suggested to decrease mortality be preventing infected, necrotic pancreatitis |
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If there is severe necrosis of the pancreas, we may also do a |
needle biopsy to determine if infection is already present |
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what is a pseudocyst? |
it's an encapsulate area of enzyme-rich fluid and tissue debris that accumulates within the pancreas and elicits a strong inflammatory response
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what happens to most pseudocysts? |
they usually resolve after pancreatitis symptoms also improve |
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what are the indications for drainage of a pseudocyst? |
if they become infected or grow over 5 cm in diameter
if they persist beyond 6 wks |
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why is the fluid so pro-inflammatory in a pseudocyst? |
because it contains high amounts of amylase and lipase |
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the biggest risk of a large pseudocyst is... |
erosion into a blood vessel |
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what antibiotics are used for severe pancreatitis? |
meropenem imipenem |
