Acute Pancreatitis
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Questions and Answers

What is the characteristic of abdominal pain in acute pancreatitis?

  • Relieved by taking alcohol or fatty food
  • Epigastric and constant (correct)
  • Radiates to the front
  • Radiates to the back
  • Why should pethidine alone be avoided in the management of acute pancreatitis?

  • It can cause respiratory failure
  • It can cause spasm of the sphincter of Oddi (correct)
  • It can cause cardiac arrest
  • It can cause gastrointestinal bleeding
  • What is a complication of acute pancreatitis?

  • Multi-organ failure (correct)
  • Cardiac arrhythmia
  • Hypertension
  • Gastrointestinal bleeding
  • What is the purpose of Ranson's criteria?

    <p>To determine the prognosis of acute pancreatitis</p> Signup and view all the answers

    What is a sign of intra/retroperitoneal bleeding in acute pancreatitis?

    <p>All of the above</p> Signup and view all the answers

    What is a common symptom of acute pancreatitis?

    <p>Nausea and vomiting</p> Signup and view all the answers

    What is the primary mechanism of acute pancreatitis?

    <p>Autodigestion of acinar cells by activated enzymes</p> Signup and view all the answers

    Which of the following laboratory tests is more specific for acute pancreatitis?

    <p>Serum lipase</p> Signup and view all the answers

    What is the primary goal of the 'R-Regimen' in treating acute pancreatitis?

    <p>Relieve pain and rest the bowel</p> Signup and view all the answers

    What is the most common cause of acute pancreatitis?

    <p>Gallstones</p> Signup and view all the answers

    What is the radiological sign of acute pancreatitis on an abdominal X-ray?

    <p>Colon cut off sign</p> Signup and view all the answers

    What is the primary role of IV fluids in the treatment of acute pancreatitis?

    <p>Resuscitate the patient</p> Signup and view all the answers

    Study Notes

    Definition and Pathophysiology of Acute Pancreatitis

    • Acute pancreatitis is the autodigestion of acinar cells of the pancreas by its own regurgitated enzymes in their active form.
    • Obstruction of the pancreatic duct leads to the return of pancreatic enzymes, causing autodigestion and destruction of acinar cells.

    Causes of Acute Pancreatitis

    • Idiopathic
    • Steroid
    • Mumps/Malnutrition/Malignancy
    • Gallstones (1st)
    • Autoimmune
    • Ethanol (alcohol) (2nd)
    • Scorpion/Spider bites
    • Trauma
    • Hyperlipidemia/Hypercalcemia/Hereditary
    • ERCP
    • Drugs/Duodenal obstruction

    Investigations for Acute Pancreatitis

    • Labs: CBC (↑WBC), Serum amylase, Serum lipase, & Urinary amylase
    • Imaging: Abdominal X-Ray, Ultrasound, & Enhanced - CT-scan
    • Serum lipase is more specific for acute pancreatitis, but not routinely done due to high cost.

    Abdominal X-Ray Signs

    • Colon cut off sign
    • Sentinel loop

    Enhanced - CT-Scan Signs

    • Pancreatic necrosis
    • Peri-pancreatic fluid

    Treatment of Acute Pancreatitis ("R-Regimen")

    • Rest: Relieve Pain, NPO, IV fluid, electrolytes replacement
    • Rest: Rest the bowel (NG tube to decompress the bowel)
    • Resist: Resist infection

    Signs and Symptoms of Acute Pancreatitis

    • Symptoms:
      • Abdominal pain (SOCRATES)
      • Nausea, vomiting
      • Dull, boring pain
    • Signs:
      • Abdominal distension
      • Jaundice
      • Inflammatory symptoms (FAHM)
      • Inflammatory signs (HTT)
      • Muscle guarding in upper abdomen & Rebound tenderness
      • Fox sign (Bruising in the inguinal ligament)
      • Grey Turner sign (Ecchymosis in the flanks)
      • Cullen's sign (Ecchymosis in the peri-umbilical region)

    Complications of Acute Pancreatitis

    • Multi-organ failure
    • Abscess formation
    • Pancreatic pseudocyst
    • Recurrent acute attacks
    • Chronic Pancreatitis
    • Dehydration, Electrolyte Imbalance, Acid-Base Imbalance, and Renal Impairment
    • Hemorrhagic, necrotic, and infective presentations
    • Hyperlipidemia
    • Hypocalcemia

    Ranson's Criteria

    • A scale used to determine the prognosis of acute pancreatitis

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    Description

    Test your knowledge about acute pancreatitis, its definition, pathophysiology, causes, and investigations. Learn about the auto-digestion of pancreatic cells and obstruction of the pancreatic duct. Get ready to diagnose and manage this condition!

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