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GI 9 Pancreatic D/O
Pancreatic disorders
| Question | Answer |
|---|---|
| What's the difference between Mallory Weiss and Boerhaave tears? | Mallory Weiss is supf mucosal tears. Boerhaave is a full-thickness perforation. |
| What statistical calculation looks at true positives and divides them by the number of patients with the disease? | Sensitivity |
| What are the HACEK bacteria? | Culture negative endocarditis: Haemophilus, Actinobacillus, Cardiobacterium, Eikenella, and Kingella |
| What are the Ranson criteria in admission for acute pancreatitis? | GA LAW: Glucose >200, AST >250, LDH >350, Age >55yo, Wt ct >16,000 |
| What are the 48h Ranson criteria in acute pancreatitis? (don't need numbers) | Hct dec >10%, Ca <8, arterial O2 <60, BUN inc >5, base deficit >4, fluid sequetration >6L |
| What is the most sensitive and specific lab test for the dx of chronic pancreatitis? | Low fecal elastase level |
| What is the tx for chronic pancreatitis? | Stop EtOH, opioid analgesia, pancreatic enzyme supplementation, and possible surgery |
| What are the MCC of acute pancreatitis in the US? | Gallstones and alcohol |
| What is the tumor marker most useful in the dx of pancreatic cancer? | CA 19-9 |
| What procedure is performed to treat an isolated cancerous tumor in the head of the pancreas? | Whipple |
| If pancreatitis is due to gallstone obstruction of pancreatic duct, what should be done after the pancreatitis has passed? | Cholecystectomy |
| Can amylase and lipase be used to predict prognosis? Which one is more specific for pancreas? | No; lipase is more specific for pancreas. |
| Name 6 drugs causing pancreatitis. | Didanosine (HIV drug), sulfa drugs, HTZ, valproid acid, AZT, estrogens |
| What is Grey Turner's sign? What dz is it seen in? | Hemorrhage into flank causing bluish discoloration. Acute pancreatitis |
| What is Cullen's sign | Periumbilical hemorrhage seen in acute pancreatitis |
| Name 2 key radiographic findings in acute pancreatitis. | Sentinel loop (dilated loops of bowel near pancreas on AXR). Colon cut-off sign (R colon distended until near pancreas) |
| Common cause of recurrent/chronic pancreatitis? | Alcohol |
| What is Courvoisier's sign? | Palpable, nontender gallbladder seen in exocrine pancreatic cancer (adenocarcinoma) |
| What does elevated alk phos suggest in a suspected pancreatic cancer case? | BIle duct obstruction. Will also see increased T bili and D bili |
| What is Trousseau's syndrome? | Migratory thrombophlebitis that is a complication of exocrine pancreatic cancer |
| Increased fasting insulin, spontaneous hypoglycemia, and positive C peptide. WHich tumor? Tx? | Insulinoma. Tx is surgical resection. Diazoxide or ocretotide may relieve symptoms in non-resectable dz. |
| Alpha cell tumor causing hyperglycemia that may present as refractory DM. Tumor? Derm finding? | Glucoagonoma. Exfoliating rash (migratory necrolytic erythema) may be found on exam. |
| Tx for glucagonoma? | surgical resection if localized, octreotide, IFN-alpha, chemo, and embolization may be used in metastatic dz. |
| Tumor of non-beta islet cells causing watery diarrhea, weakness, nausea, vomiting, and abdominal pain. | VIPoma |
| Multiple insulinomas are indicative of ___. | MEN I |
| What type of diarrhea does a VIPoma cause? | Secretory (check stool osmolality) |
| Tx for VIPoma? | surgical resection if localized, corticosteroids, chemo, octreotide, and embolization may be used in metastatic dz. |
Created by:
sarah3148
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