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27 Cards in this Set
- Front
- Back
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Exocrine Function of the Pancreas
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Pancreatic Enzymes:
*Trypsinogen *Chymotrypsin *Amylase *Lipase |
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Endocrine Function of the Pancreas
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*Insulin Production
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Acute Pancreatitis
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-Inflammatory response
-Mild edema-edamatous pancreatitis -Hemorrhagic necrosis-necrotizing pancreatitis |
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Acute Pancreatitis Etiology
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-Obstruction of bile back flow
-Alcoholism -Gallbladder Disease |
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Pathology of Pancreatitis
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-Autodigestion of pancreas
-Enzymes are activated in pancreas instead of duodenum |
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Manifestations of Pancreatitis
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-Abdominal pain in LUQ or midepigastric
-Decreased or absent bowel sounds -Abdominal distention -n/v -fever -leukocytes -hypotension (due to bleeding) -tachycardia (sns) -jaundice -Grey Turner Sign -Cullen's sign |
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Grey Turner Sign
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Bluish (ecchymosis) flank discoloration caused by seepage of blood stained exudate from the pancreas and may occur in server cases
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Cullen's Sign
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A bluish (ecchymosis) periumbilical discoloration caused by seepage of blood stained exudate from the pancreas and may occur in sever cases
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Complication of Pancreatitis
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-Pseudocyst-Cavity within or surrounding the pancreas (may be palpable) filled with necrotic products and liquid secretions. Granulation tissue least to encapsulation of exudate.
-Abscess |
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Systemic complications of Pancreatitis
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-Pulmonary
-CV -Tetany -Decrease Ca+ level |
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Diagnostic studies for Pancreatitis
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-Serum Amylase increased (greater than 200 U/L)
-Serum lipase-elevated -Urinary amylase- elevated, may last several days after serum levels decrease -Hyperglycemia -Hyperlipidemia -Hypocalcemia |
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Increase of both serum amylase and lipase typically means
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Pancreatitis
*Only and increase in amylase = liver problems |
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Diagnostic studies for pancreatitis
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-Abdominal ultrasound
-CT scan -ERCP-Endoscopic Retrograde Cholangiopancreatography |
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Treatment for Acute Pancreatitis
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-Pain relief
-F&E replacement (Ca+, K+) -Bowel/pancreatic rest -NPO to rest pancreas -Antibiotics -Surgical Therapy |
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Chronic Pancreatitis
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-Structural changes occurring within the pancreas
-Functional capabilities decline (esp. exocrine) -Weight loss -Loss of ability to ingest and absorb -Development of DM |
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With Chronic Pancreatitis malabsorption of what often occurs?
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Fat soluble Vits
ADEK |
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The goal for Chronic Pancreatitis
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Replace Amylase and LIpase
*Levels may be high, low or normal with chronic pancreatitis |
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Management of Chronic Pancreatitis
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-Avoidance of alcohol
-Medication therapy -Dietary changes -Depression |
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Rx for Chronic Pancreatitis
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-Viokase
-Cotazym *enzymes that allow us to digest what we eat |
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Pancreatic Cancer
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-Peak incidence 65-80 years
-Adenocarcinoma -Occurs most often in the head of the pancreas -CBD becomes obstructed with tumor growth -Pt's typically die within 5-12 months after diagnosis |
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Risk factors for pancreatic cancer
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-Smoking
-High fat diet -diabetes -exposure to chemicals |
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Manifestations of Pancreatic Cancer
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-Abdominal pain
-Anorexia -Weight loss -Nausea -Jaundice (with obstruction) |
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Diagnostic Studies for PAncreatic Cancer
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*Usually only detected with advanced stages
-Abdominal ultrasound -CT scan -ERCP -Tumor Markers |
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Tumor markers present with PAncreatic Cancer
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-CA19-9
-GB CEA |
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ERCP
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-Endoscope for pancreas into common bile and pancreatic ducts
*Can cause pancreatitis |
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Treatment for Pancreatic Cancer
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-Surgery: Whipple's procedure,Radical pancreaticodudoenectomy
-Total pancreatectomy -Relieve biliary obstruction -Radiation Therapy: External and internal implantation seed |
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Whipple Procedure
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-Resection of the proximal pancreas, the adjoining duodenum, the distal segment of the common bile duct.
-An anastomosis of the pancreatic duct, common bile duct and stomach jejunum is done. |
