NMNC 4510- Concepts (New Content)-
Questions and All Correct Answers.
What are the main exocrine enzymes and what do they do? (pancreas) - Answer Amylase-
starch breakdown
Lipase- fat breakdown
Chymotrypsin/Trypsinogen- protein breakdown
What are the islets of Langerhans? (Endocrine/Pancreas) - Answer β- insulin and amylin
α- glucagon
δ- somatostatin
F cells- pancreatic polypeptide
What happens during acute pancreatitis? - Answer Injured pancreatic cells or pancreatic
enzymes leak into pancreatic tissue "autodigestion" (eating itself)
What is the most common cause of pancreatitis and is more common in women? - Answer
Gallstone (obstruction)
What is the most common cause of pancreatitis and is more common in men? - Answer
Chronic alcohol use
What are the clinical manifestations of acute pancreatitis? - Answer - Abdominal pain (LUQ,
mid-epigastric, radiates to back)
- Severe, deep, piercing
- Exacerbated w/foods
- No relief w/ vomiting (recumbent position- fetal position, side-lying/supine)
- Decreased/absent bowels
- Crackles-lungs
What is Cullen's and Grey Turner's sign, and when does it occur? - Answer
Hemorrhagic/exudate leaks into interstitial space
Cullen's: belly button bruise
Grey Turner's: flank/back bruise
What is a pancreatic pseudocyst? - Answer LOCAL: Collection of leaked pancreatic fluids;
typically resolves (otherwise requires surgery)
, - Increased amylase
- Abd pain, anorexia, palpable epigastric mass, n/v
What is a pancreatic abscess? - Answer LOCAL: Infected pseudocyst; requires surgical drainage
to prevent sepsis
- Upper abd pain, fever, abd mass, can rupture/perforate into nearby organs
What are systemic complications in acute pancreatitis? - Answer Cardiogenic: thrombi, PE,
DIC, hypo
Resp: atelectasis, pleural effusions, ARDS
Severe: abd compartment syndrome
What electrolyte is affected in acute pancreatitis? - Answer HYPOCALCEMIA (calcium binds to
fatty acids)
Chvostek - cheek twitch
Trousseau- hand contracts w/ inflated BP cuff
What are your MAJOR diagnostics for pancreatitis? - Answer Serum amylase/lipase (HIGH)
CT, EUS, ERCP (caution can cause pancreatitis), stool sample (chronic)
What conservative therapy can you use for pancreatitis? - Answer - IV opioids
- Glucose monitoring
- F/E
- Bowel rest (NPO, EN prn)
- Small frequent meals
What kind of diet do you eat with pancreatitis? - Answer Increased carbs/proteins, decrease
fats
What medications should be given with pancreatitis? - Answer Antacids- neutralize HCL
/decrease pancreatic enzymes
Antispasmodics- decrease vagal stim.
Carbonic anhydrase inhibitor- decrease volume of bicarb
Morphine- pain
PPI- decrease HCL
Questions and All Correct Answers.
What are the main exocrine enzymes and what do they do? (pancreas) - Answer Amylase-
starch breakdown
Lipase- fat breakdown
Chymotrypsin/Trypsinogen- protein breakdown
What are the islets of Langerhans? (Endocrine/Pancreas) - Answer β- insulin and amylin
α- glucagon
δ- somatostatin
F cells- pancreatic polypeptide
What happens during acute pancreatitis? - Answer Injured pancreatic cells or pancreatic
enzymes leak into pancreatic tissue "autodigestion" (eating itself)
What is the most common cause of pancreatitis and is more common in women? - Answer
Gallstone (obstruction)
What is the most common cause of pancreatitis and is more common in men? - Answer
Chronic alcohol use
What are the clinical manifestations of acute pancreatitis? - Answer - Abdominal pain (LUQ,
mid-epigastric, radiates to back)
- Severe, deep, piercing
- Exacerbated w/foods
- No relief w/ vomiting (recumbent position- fetal position, side-lying/supine)
- Decreased/absent bowels
- Crackles-lungs
What is Cullen's and Grey Turner's sign, and when does it occur? - Answer
Hemorrhagic/exudate leaks into interstitial space
Cullen's: belly button bruise
Grey Turner's: flank/back bruise
What is a pancreatic pseudocyst? - Answer LOCAL: Collection of leaked pancreatic fluids;
typically resolves (otherwise requires surgery)
, - Increased amylase
- Abd pain, anorexia, palpable epigastric mass, n/v
What is a pancreatic abscess? - Answer LOCAL: Infected pseudocyst; requires surgical drainage
to prevent sepsis
- Upper abd pain, fever, abd mass, can rupture/perforate into nearby organs
What are systemic complications in acute pancreatitis? - Answer Cardiogenic: thrombi, PE,
DIC, hypo
Resp: atelectasis, pleural effusions, ARDS
Severe: abd compartment syndrome
What electrolyte is affected in acute pancreatitis? - Answer HYPOCALCEMIA (calcium binds to
fatty acids)
Chvostek - cheek twitch
Trousseau- hand contracts w/ inflated BP cuff
What are your MAJOR diagnostics for pancreatitis? - Answer Serum amylase/lipase (HIGH)
CT, EUS, ERCP (caution can cause pancreatitis), stool sample (chronic)
What conservative therapy can you use for pancreatitis? - Answer - IV opioids
- Glucose monitoring
- F/E
- Bowel rest (NPO, EN prn)
- Small frequent meals
What kind of diet do you eat with pancreatitis? - Answer Increased carbs/proteins, decrease
fats
What medications should be given with pancreatitis? - Answer Antacids- neutralize HCL
/decrease pancreatic enzymes
Antispasmodics- decrease vagal stim.
Carbonic anhydrase inhibitor- decrease volume of bicarb
Morphine- pain
PPI- decrease HCL
