Term
| In appropriate activation of pancreatic enzyme precursors w/i the pancreas, leading to autodigestion, necrosis, edema, and hemorrhage. |
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Definition
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Term
| What is the most common cause of acute pancreatitis? Second? |
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Definition
| Alcohol abuse. Cholelithiasis. |
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Term
| Acute pancreatitis is thought to result from direct injury to ____, possibly from reflux of ____ into the pancreas. |
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Definition
| Pancreatic acinar cells. Bile. |
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Term
| Name 3 risk factors for acute pancreatitis. |
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Definition
| Etohism, elev. cholesterol or triglycerides, and untreated PUD |
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Term
| What is the classic presentation of acute pancreatitis? |
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Definition
| Epigastric pain radiating to the back 1-4hrs /p eating a large meal or etoh |
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Term
| What is the alleviating factor of the pain experienced by a pt w/ acute pancreatitis? |
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Definition
| When they lean forward or lie in fetal position |
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Term
| What are 2 signs that may be present in a pt w/ severe necrotizing pancreatitis? |
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Definition
| Cullen's sign - cyanotic skin around umbilicus. Turner's sign - ecchymosis of the flanks. |
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Term
| What lab finding are typ. present in acute pancreatitis? |
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Definition
| Elev. lipase/amylase, WBC, and liver enzymes (d/t biliary obs.) |
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Term
| Name 4 complications of acute pancreatitis. |
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Definition
| 1)Prerenal azotemia or ATN 2)Sterile or infected necrotizing pancreatitis 3)ARDS 4)Pancreatic abscess or pseudocyst |
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Term
| What is the most likely complication of acute pancreatitis? |
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Definition
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Term
| what is a common surgical consult for a pt w/ acute pancreatitis? |
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Definition
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Term
| The presence of what in a pt w/ acute pancreatitis has a grave prognosis? |
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Definition
| Hypovolemia, ARDS, and tachycardia (>130bpm) |
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Term
| When are recurrences of acute pancreatitis common? |
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Definition
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Term
| Chronic pancreatitis is a characterized by chronic pain or recurrent episodes of acute pancreatitis and ultimately by _____. |
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Definition
| Pancreatic endocrine or exocrine insufficiency |
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Term
| Most cases of chronic pancreatitis in the US are related to what? |
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Definition
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Term
| Name 4 other causes of chronic pancreatitis. |
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Definition
| Hyperparathyroidism, severe malnutrition, obs. of pancreatic duct, idiopathic |
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Term
| What is the SAPE hypothesis relating to chronic pancreatitis? |
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Definition
| Sentinel acute pancreatitis event - The first acute pancreatitis event initiates an inflammatory process that results in injury and later fibrosis. |
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Term
| What is the classic triad of sx that occurs in ~20% of cases of chronic pancreatitis? |
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Definition
| Pancreatic calcification, steatorrhea, and DM |
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Term
| Name 3 physcial findings in chronic pancreatitis during an acute attack. |
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Definition
| Tenderness over pancreas, muscle guarding, and ileus |
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Term
| What is the tx/management of chronic pancreatitis? |
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Definition
| Avoid etoh and fatty foods, pancreatic enzyme replacement, B12 injections if malabsorption, acid reducer |
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Term
| Where are the majority of pancreatic CA located? |
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Definition
| ~75% in the head of pancreas |
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Term
| Name 6 risk factors for pancreatic CA. |
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Definition
| Inc. age, obesity, tobacco, chronic pancreatitis, h/o abd XRT, family hx |
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Term
| What is Courvoisier's sign? |
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Definition
| Jaundice and palpable GB w/ CA of pancreatic head |
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Term
| What is a palpable, hard periumbilical nodule seen in advanced cases of pancreatic CA called? |
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Definition
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Term
| What is occult blood in the stool suggestive of if pancreatic CA is suspected? |
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Definition
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Term
| what is the most common initial diagnostic procedure performed for pancreatic CA? |
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Definition
| Multiphase helical CT scan |
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Term
| What is the common surgery performed for CA of the pancreatic head /s mets? |
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Definition
| Whipple (pancreaticoduodenectomy) |
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Term
| What type of pancreatic CA has the worst survical rate? |
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Definition
| Body and tail - 2-5% 5 yr survival rate |
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