Podcast
Questions and Answers
Which of the following best describes the pathophysiology of pancreatitis?
Which of the following best describes the pathophysiology of pancreatitis?
- Premature activation of pancreatic enzymes leading to autodigestion (correct)
- Chronic inflammation of the liver due to alcohol abuse
- Autoimmune destruction of pancreatic islet cells
- Mechanical obstruction of the common bile duct without inflammation
Which of the following are direct consequences of autodigestion in pancreatitis? Select all that apply:
Which of the following are direct consequences of autodigestion in pancreatitis? Select all that apply:
- Increased insulin secretion
- Necrosis (correct)
- Hemorrhage (correct)
- Inflammation (correct)
- Gallstone formation
The reflux of duodenal contents into the pancreatic duct is most associated with which of the following?
The reflux of duodenal contents into the pancreatic duct is most associated with which of the following?
- Pancreatic duct stricture
- Distention of the Sphincter of Oddi (correct)
- Duodenal ulcer
- Portal hypertension
A nurse is caring for a patient with acute pancreatitis. Which order should be questioned?
A nurse is caring for a patient with acute pancreatitis. Which order should be questioned?
Which are types of pancreatitis? Select all that apply:
Which are types of pancreatitis? Select all that apply:
Which finding best explains worsening symptoms in a patient with acute pancreatitis?
Which finding best explains worsening symptoms in a patient with acute pancreatitis?
A patient develops necrotizing pancreatitis. What is the priority nursing concern?
A patient develops necrotizing pancreatitis. What is the priority nursing concern?
Which clinical complications result from pancreatic enzyme activation inside the pancreas? Select all that apply:
Which clinical complications result from pancreatic enzyme activation inside the pancreas? Select all that apply:
A patient has worsening LUQ pain after a fatty meal. Which condition is most likely responsible?
A patient has worsening LUQ pain after a fatty meal. Which condition is most likely responsible?
Which mechanism contributes to the development of pancreatitis?
Which mechanism contributes to the development of pancreatitis?
What is the most common cause of pancreatitis?
What is the most common cause of pancreatitis?
Which of the following are risk factors for developing pancreatitis? Select all that apply:
Which of the following are risk factors for developing pancreatitis? Select all that apply:
A nurse is reviewing the chart of a patient who developed pancreatitis. Which finding in the history is most concerning?
A nurse is reviewing the chart of a patient who developed pancreatitis. Which finding in the history is most concerning?
Which of the following are common causes of pancreatitis seen in clinical practice? Select all that apply:
Which of the following are common causes of pancreatitis seen in clinical practice? Select all that apply:
A pregnant patient in her third trimester presents with LUQ pain. What should the nurse suspect?
A pregnant patient in her third trimester presents with LUQ pain. What should the nurse suspect?
A patient with a history of heavy alcohol use presents with abdominal pain and nausea. Labs reveal elevated lipase. What is the likely diagnosis?
A patient with a history of heavy alcohol use presents with abdominal pain and nausea. Labs reveal elevated lipase. What is the likely diagnosis?
Which patients are at increased risk for developing chronic pancreatitis? Select all that apply:
Which patients are at increased risk for developing chronic pancreatitis? Select all that apply:
A patient presents with suspected pancreatitis. What in the history increases suspicion the most?
A patient presents with suspected pancreatitis. What in the history increases suspicion the most?
A patient on chronic steroid therapy is admitted with acute epigastric pain and vomiting. What is the most likely underlying cause?
A patient on chronic steroid therapy is admitted with acute epigastric pain and vomiting. What is the most likely underlying cause?
Approximately how many hospitalizations per year in the U.S. are attributed to pancreatitis?
Approximately how many hospitalizations per year in the U.S. are attributed to pancreatitis?
Which symptom is most characteristic of acute pancreatitis?
Which symptom is most characteristic of acute pancreatitis?
Which of the following are signs or symptoms of acute pancreatitis? Select all that apply:
Which of the following are signs or symptoms of acute pancreatitis? Select all that apply:
Which clinical finding suggests hemorrhagic pancreatitis?
Which clinical finding suggests hemorrhagic pancreatitis?
A nurse notes bluish discoloration on a patient's flank area. What action is most appropriate?
A nurse notes bluish discoloration on a patient's flank area. What action is most appropriate?
Which are classic signs of chronic pancreatitis? Select all that apply:
Which are classic signs of chronic pancreatitis? Select all that apply:
A patient with chronic pancreatitis presents with weight loss and greasy stools. What is the most likely cause?
A patient with chronic pancreatitis presents with weight loss and greasy stools. What is the most likely cause?
A patient reports worsening pain after alcohol use. Which condition should the nurse suspect?
A patient reports worsening pain after alcohol use. Which condition should the nurse suspect?
Which complications are more common in chronic pancreatitis? Select all that apply:
Which complications are more common in chronic pancreatitis? Select all that apply:
What sign is described as bruising on the flanks?
What sign is described as bruising on the flanks?
A patient with chronic pancreatitis reports dark urine. Which pathophysiologic process best explains this?
A patient with chronic pancreatitis reports dark urine. Which pathophysiologic process best explains this?
Which of the following is a potential life-threatening complication of acute pancreatitis?
Which of the following is a potential life-threatening complication of acute pancreatitis?
Which are common complications associated with pancreatitis? Select all that apply:
Which are common complications associated with pancreatitis? Select all that apply:
A patient with pancreatitis has fever, increased WBCs, and a fluid-filled mass on CT. What is the most likely diagnosis?
A patient with pancreatitis has fever, increased WBCs, and a fluid-filled mass on CT. What is the most likely diagnosis?
Which complications should the nurse monitor for in a patient with pancreatic necrosis? Select all that apply:
Which complications should the nurse monitor for in a patient with pancreatic necrosis? Select all that apply:
Which respiratory complication is associated with acute pancreatitis?
Which respiratory complication is associated with acute pancreatitis?
A patient with chronic pancreatitis is losing weight despite adequate intake. What is the likely cause?
A patient with chronic pancreatitis is losing weight despite adequate intake. What is the likely cause?
Which of the following is the main cause of diabetes mellitus in chronic pancreatitis?
Which of the following is the main cause of diabetes mellitus in chronic pancreatitis?
Which statements are true regarding pancreatic pseudocysts? Select all that apply:
Which statements are true regarding pancreatic pseudocysts? Select all that apply:
A patient has LUQ pain, fever, and signs of sepsis weeks after acute pancreatitis. What is the best interpretation?
A patient has LUQ pain, fever, and signs of sepsis weeks after acute pancreatitis. What is the best interpretation?
Which lab finding would support multi-organ dysfunction due to pancreatitis?
Which lab finding would support multi-organ dysfunction due to pancreatitis?
Which lab test is most specific for diagnosing pancreatitis?
Which lab test is most specific for diagnosing pancreatitis?
Which diagnostic imaging studies are commonly used to evaluate pancreatitis? Select all that apply:
Which diagnostic imaging studies are commonly used to evaluate pancreatitis? Select all that apply:
Which diagnostic tool allows both visualization and intervention (like stone removal) in biliary pancreatitis?
Which diagnostic tool allows both visualization and intervention (like stone removal) in biliary pancreatitis?
A patient with pancreatitis has elevated lipase and amylase. What action by the nurse is most appropriate?
A patient with pancreatitis has elevated lipase and amylase. What action by the nurse is most appropriate?
A patient with RUQ pain undergoes an ultrasound, revealing gallstones. What’s the likely connection to their pancreatitis?
A patient with RUQ pain undergoes an ultrasound, revealing gallstones. What’s the likely connection to their pancreatitis?
Flashcards
Pathophysiology of Pancreatitis
Pathophysiology of Pancreatitis
Premature activation of pancreatic enzymes, causing the pancreas to digest itself.
Direct Consequences of Autodigestion
Direct Consequences of Autodigestion
Inflammation, hemorrhage, and necrosis due to autodigestion in pancreatitis.
Sphincter of Oddi and Pancreatitis
Sphincter of Oddi and Pancreatitis
A distended Sphincter of Oddi allows duodenal contents to reflux into the pancreatic duct, activating enzymes.
Why NPO for Acute Pancreatitis?
Why NPO for Acute Pancreatitis?
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Types of Pancreatitis
Types of Pancreatitis
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Elevated Amylase in Pancreatitis
Elevated Amylase in Pancreatitis
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Necrotizing Pancreatitis Priority
Necrotizing Pancreatitis Priority
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Clinical Results From Enzyme Activation
Clinical Results From Enzyme Activation
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Triggers of Chronic Pancreatitis Pain
Triggers of Chronic Pancreatitis Pain
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Pancreatitis Development Mechanism
Pancreatitis Development Mechanism
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Most Common Pancreatitis Cause
Most Common Pancreatitis Cause
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Pancreatitis Risk in Pregnancy
Pancreatitis Risk in Pregnancy
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Classic Signs of Chronic Pancreatitis
Classic Signs of Chronic Pancreatitis
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Malabsorption in Chronic Pancreatitis
Malabsorption in Chronic Pancreatitis
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Alcohol and Pancreatitis Pain
Alcohol and Pancreatitis Pain
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Turner's Sign
Turner's Sign
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Diabetes Mellitus in Chronic Pancreatitis
Diabetes Mellitus in Chronic Pancreatitis
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Pancreatic Pseudocyst Characteristics
Pancreatic Pseudocyst Characteristics
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Specific Lab for Pancreatitis
Specific Lab for Pancreatitis
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Gallstones' Role in Pancreatitis
Gallstones' Role in Pancreatitis
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Study Notes
Pathophysiology of Pancreatitis
- Pancreatitis involves premature activation of pancreatic enzymes, leading to autodigestion
- Autodigestion results in inflammation, hemorrhage, and necrosis of the pancreas
- Reflux of duodenal contents into the pancreatic duct can cause enzyme activation due to distention of the Sphincter of Oddi
- Acute pancreatitis requires NPO (nothing by mouth) status to allow the pancreas to rest
- Elevated serum amylase indicates worsening autodigestion and inflammation
- Risk for infection is the priority concern in necrotizing pancreatitis
- Clinical complications from pancreatic enzyme activation include hemorrhage, inflammation, and necrosis
- Chronic pancreatitis pain is exacerbated by fatty meals and alcohol
- Pancreatitis development is contributed to by blockage of pancreatic enzyme excretion
Etiology, Incidence, and Risk Factors
- Gallstones are the #1 cause of pancreatitis, particularly in acute cases because they obstruct the pancreatic duct
- Risk factors for developing pancreatitis include chronic alcohol use, gallbladder attacks, pregnancy (especially in the third trimester), and infection
- Long-term corticosteroid therapy increases the risk for pancreatitis
- Common causes of pancreatitis seen in clinical practice are gallstones, heavy alcohol use, and obstruction of pancreatic ducts
- Pregnancy in the third trimester is a risk factor for pancreatitis, likely due to biliary sludge or gallstones
- Heavy alcohol use and elevated lipase levels is an indicator of pancreatitis
- Risk factors for chronic pancreatitis are long-term alcohol use, multiple gallbladder attacks, and genetic predisposition
- Acute alcohol use, especially binge drinking, is a precipitating factor for acute pancreatitis
- Chronic steroid use is a risk factor and must be considered in the differential for acute gastrointestinal (GI) symptoms
- Approximately 100,000 hospitalizations occur annually in the U.S. due to pancreatitis
Clinical Manifestations of Acute & Chronic Pancreatitis
- Acute pancreatitis is characterized by severe epigastric pain that often radiates to the back
- Signs and symptoms of acute pancreatitis include nausea, vomiting, Cullen's sign, abdominal distention, and decreased bowel sounds
- Cullen's sign (bruising around the umbilicus) indicates intra-abdominal bleeding, often seen in hemorrhagic pancreatitis
- Bluish discoloration on a patient's flank area indicates Turner's Sign, suggesting retroperitoneal bleeding and needing prompt evaluation
- Classic signs of chronic pancreatitis are LUQ abdominal pain, steatorrhea, weight loss, and jaundice
- Pancreatic enzyme deficiency leads to malabsorption and steatorrhea in chronic pancreatitis
- Chronic pancreatitis pain increases with alcohol or fatty meals due to pancreatic stimulation
- Common complications in chronic pancreatitis include steatorrhea, diabetes mellitus, and malabsorption
- Turner's sign is bruising along the flanks, indicating severe pancreatitis due to retroperitoneal hemorrhage
- In chronic pancreatitis, dark urine may be caused by excess bile in the bloodstream
Complications of Pancreatitis
- A life-threatening complication of acute pancreatitis is pancreatic pseudocyst rupture, potentially causing hemorrhage, infection, and peritonitis
- Common complications associated with pancreatitis include pancreatic necrosis, abscess formation, respiratory complications, and pseudocysts
- Fever, increased WBCs, and a fluid-filled mass on CT points towards an infected pancreatic pseudocyst
- Pancreatic necrosis needs monitoring for sepsis, multi-organ dysfunction, and pancreatic abscess because necrotic pancreatic tissue can become a breeding ground for infection
- A respiratory complication associated with acute pancreatitis is pleural effusion, resulting from inflammatory mediators affecting the lungs and leading to pleural effusions or ARDS
- Chronic pancreatitis causes malabsorption due to a lack of digestive enzymes, leading to weight loss
- Damage to islets of Langerhans is the main cause of diabetes mellitus in chronic pancreatitis
- Pancreatic pseudocysts may resolve spontaneously, can rupture (causing internal bleeding), are encapsulated fluid collections, and can compress nearby organs
- LUQ pain, fever, and signs of sepsis weeks after acute pancreatitis suggests pancreatic necrosis with abscess
Diagnostics, Labs & Imaging
- Elevated bilirubin and rising creatinine suggest multi-organ involvement (liver dysfunction and renal impairment)
- Serum lipase is most specific for diagnosing pancreatitis and remains elevated longer
- Diagnostic imaging studies to evaluate pancreatitis include CT scan, ultrasound, MRCP, and ERCP
- ERCP allows direct visualization and intervention (like stone removal) in the biliary and pancreatic ducts
- Elevated pancreatic enzymes with symptoms suggest active pancreatitis which requires holding oral intake (NPO)
- Gallstones cause backflow of enzymes by obstructing the common bile duct or pancreatic duct which leads to pancreatitis
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