Pancreatitis Study Notes

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Questions and Answers

Which of the following is a common sign and symptom of pancreatitis?

Epigastric pain that radiates to the left flank or shoulder (correct)

Severe headache accompanied by visual disturbances

Severe sharp pain localized only in the right upper quadrant

Loss of sensation in the extremities

What is the primary laboratory finding that is specific to pancreatitis?

Elevated triglycerides

Decreased calcium

Elevated lipase (correct)

Elevated amylase

Which management strategy is recommended for patients with acute pancreatitis?

Keep the patient NPO until they are pain-free (correct)

Administer pancreatic enzymes before each meal

Increase physical activity to improve pancreatic function

Encourage high fat meals to promote digestion

What does Cullen’s sign indicate in a patient with pancreatitis?

Periumbilical bruising Signup and view all the answers

Which factor is associated with chronic pancreatitis management?

Daily weights should be monitored Signup and view all the answers

Which of the following complications can occur due to pancreatitis?

Hypovolemic shock Signup and view all the answers

What physiologic condition does Trousseau’s sign indicate in a patient with pancreatitis?

Hypocalcemia Signup and view all the answers

What positions can help alleviate pain in a patient suffering from acute pancreatitis?

Fetal position or sitting upright and bending forward Signup and view all the answers

Which lab finding is likely to be elevated in a patient experiencing acute pancreatitis?

Amylase Signup and view all the answers

What is the hallmark sign of acute pancreatitis pain?

Epigastric pain that radiates to the back and left flank Signup and view all the answers

Which medication is NOT recommended for managing chronic pancreatitis?

Asprin Signup and view all the answers

In the management of acute pancreatitis, what is the recommended dietary approach?

Avoid high fat foods and heavy meals Signup and view all the answers

What characterizes chronic pancreatitis in terms of patient experience?

Discomfort noted with eating Signup and view all the answers

What laboratory finding is associated with inflammation in pancreatitis?

Increased erythrocyte sedimentation rate Signup and view all the answers

Which sign indicates periumbilical bruising in pancreatitis?

Cullen’s sign Signup and view all the answers

Study Notes

Pancreatitis: Study Notes

Definition:
- Acute: An inflammatory process where activated pancreatic enzymes cause self-digestion of the pancreas.
- Chronic: A progressive and destructive disease characterized by inflammation and fibrosis of the pancreas.

Symptoms (S/S):

Pain: Severe, piercing pain radiating to the back, left flank, or shoulder. Often improves in the fetal position or leaning forward.
Nausea and Vomiting (N/V): Common symptom.
Weight Loss: Frequent in chronic pancreatitis.
Jaundice: Generalized yellowing of the skin and whites of the eyes.
Cullen's Sign: Periumbilical bruising (bluish grey).
Grey Turner's Sign: Ecchymosis (bruising) on the flanks.
Trousseau's Sign: Hand spasms when a blood pressure cuff is inflated (due to hypocalcemia).
Chvostek's Sign: Facial twitching when the facial nerve is tapped (due to hypocalcemia).
Steatorrhea: Fatty, foul-smelling stools.

Diagnostic Labs:

Amylase: Elevated, but returns to normal faster than Lipase.
Lipase: Elevated (more specific for pancreatitis).
Triglycerides: Elevated.
Blood Glucose: Elevated (pancreas not producing sufficient insulin).
Erythrocyte Sedimentation Rate (ESR): Elevated (indicates inflammation).
Calcium: Decreased (associated with Chvostek's/Trousseau's signs).
White Blood Cell (WBC) Count: Elevated (signifies inflammation).

Management:

Acute Pancreatitis:
- Diet: Avoid high-fat foods, heavy meals, alcohol.
- Medications: Opioids (morphine, ketorolac, hydromorphone), IV fluids (for dehydration), pancreatic enzymes with meals (not with protein only).
- NPO (Nothing by mouth): Until pain-free and able to eat, and lipase levels decline
- Other: NG tube, assess blood sugar (BSL) frequently, TPN, avoid smoking/alcohol/stress. Fetal, side lying, HOB elevated positioning. For acute necrotizing pancreatitis, give Imipenem.
Chronic Pancreatitis:
- Diet: Expect discomfort after eating. Daily weights.
- Medications: Cimetidine, Omeprazole, pancreatic enzymes (sprinkle on food, drink water, after tidine/prazole). Take with every meal/snack.

Pain Management (Important Note):

Pain is a hallmark symptom of pancreatitis, and pain management is crucial.
Position patients in ways to potentially reduce pain (fetal position, sitting up, leaning forward).

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Description

This quiz covers essential information about pancreatitis, including its definition, symptoms, and diagnostic indicators. It outlines acute versus chronic pancreatitis and provides details on specific signs that are crucial for identification and understanding of the condition. Essential for medical students and healthcare professionals.