Term
endocrine cells of the pancreas:
hormones: |
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Definition
| islets of langerhans - insulin & glucagon |
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Term
| exocrine cells of the pancreas: |
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Definition
1. acinar cells - digestive enzymes
2. ductal cells - fluids & lytes |
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Term
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Definition
| inappropriate activation of pancreatic enzymes within the pancrease leading to autodigestion, necrosis, edema & hemorrhage |
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Term
| most common cause of pancreatitis: |
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Definition
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Term
| second most common cause of pancreatitis: |
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Definition
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Term
| pathophysiology of pancreatitis: |
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Definition
| reflux of bile into the pancreas causes damage to acinar cells which then leak enzymes into surrounding tissue. Could be stone blocking pancreatic duct also leading to auto-digestion from build up of exymes inside pancreas.Another is vascular ischemia of the acinar cells causing damage and release of enzymes |
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Term
| 3 risk factors for pancreatitis: |
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Definition
1. xs etoh
2. xs cholesterol/triglycerides
3. untx peptic ulcer dz |
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Term
| clinical presentation of pancreatitis: |
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Definition
1. epigastric pain radiating to back 1-4 hrs after eating or drinking etoh
2. alleviated by leaning forward or fetal position
3. N/V/Fvr
4. tachycardia
5. HYPOTN |
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Term
| pacreatitis phys exam findings: |
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Definition
1. epigastric tenderness
2. abd distension
3. decreased to absent bowel sounds from paralytic ileus
4. ascites
5. mild jaundice |
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Term
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Definition
| bluish discoloration of skin around umbilicus from retroperitoneal bleeding in acute pancreaitis or ectopic preg |
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Term
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Definition
| assoc w hemorrhagic (bleeding) pancreatitis, bruising of the flanks |
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Term
| pulmonary findings in pancreatitis: |
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Definition
| 10-20% have basilar rales and pleural effusion |
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Term
| 4 complications of pancreatitis: |
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Definition
1. prerenal azotemia or acute tubular necrosis > renal failure
2. necrotizing pancreatitis
3. ARDS
4. Pancreatic Abcess or pseudocyst |
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Term
| pathophys of renal failure from pancreatitis: |
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Definition
| inflammation w/n the peritoneal cavity irritates the bowel and causes an ileus, stasis in the bowel causes osmotic pull of fluid into the bowel leading to hypovolemia in the vessels which leads to decreased RBF & kidney failure |
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Term
| pathophysiology of ARDS assoc w pancretitis: |
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Definition
| ARDS is due to damage of the alveolar epithelium due to systemic inflammation |
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Term
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Definition
1. NPO (IV & consider parenteral nutrition)
2. bed rest
3. NG for ileus & severe pain
4. opiods for pain
5. Abx if indicated |
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Term
| pancreatitis has a grave prognosis w: |
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Definition
| Assoc ARDS, hypovolemia, tachycardia |
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Term
| most cases of chronic pancreatitis are caused by: |
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Definition
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Term
| 4 causes for chronic pancreatitis besides alcoholism: |
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Definition
1. hyperparathyroidism
2. severe malnutrition
3. obstruction of pancreatic duct
4. idiopathic |
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Term
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Definition
| Sentinel Acute Pancreatitis Event; first event results in fibrosis>dysfunction |
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Term
| chronic pancreatitis clinical presentation: |
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Definition
| chronic epigastric pain radiating to back, anorexia, nausea, vomiting, constipation, flatulence, weight loss, steatorrhea, mild muscle gaurding, ileus |
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Term
| seen in 30% of plain films in chronic pancreatitis: |
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Definition
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Term
| 6 complications of chronic pancreatitis: |
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Definition
1. opiod addiction
2. DM
3. pancreatic pseudocyst/abcess
4. common bile duct stricture
5. malnutrition
6. PUD |
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Term
| tx/mgt of chronic pancreatitis: 6 |
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Definition
1. avoid etoh/fatty foods
2. pancreatic enzyme replacement
3. B12 injections
4. antacid/H2a/PPI
5. tx assoc DM
6. surgical referal |
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Term
| treating uncontrolled __________ can pervent future attacks in chronic pancreatitis: |
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Definition
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Term
| about 75% of pancreatic cancers are located: |
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Definition
| in the head of the pancreas |
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Term
| 6 risk factors for pancreatic cancer: |
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Definition
1. age
2. obesity
3. tobacco
4. chronic pancreatitis
5. previous abd radiation
6. FHx |
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Term
| describe the abd pain in pancreatic CA |
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Definition
| vague, diffuse, often radiating to back |
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Term
| 4 clinical presentations of pancreatic CA |
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Definition
1. Abd pain
2. jaundice
3. diarrhea
4. weight loss |
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Term
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Definition
| painless jaundice and palpable GB in pancreatic cancer |
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Term
| Sister mary josephs sign: |
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Definition
| hard periumbilical nodule may be palpable in advanced cases of pancreatic cancer |
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Term
| occult blood in stool assoc w pancreatic CA indicates: |
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Definition
| carcinoma of Ampula of Vater |
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Term
| 4 dx studies for pancreatic CA: |
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Definition
1. helical CT
2. endoscopic US (more sensitive)
3. MRI
4. ERCP |
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Term
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Definition
| tumor limited to pancreas, 2cm or less |
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Term
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Definition
| tumore limited to pancreas, >2cm |
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Term
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Definition
| tumor extends beyond pancreas |
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Term
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Definition
| tumor extends beyond pancreas to celiac axis/SMA |
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Term
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Definition
1. surgical recision in those wo metastasis
2. radiation/chemotherapy (controversial) |
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Term
| what indicates better prognosis of pancreatic ca: |
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Definition
| lesioins of the head and ampula |
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