Mock35 Acute Pancreatitis

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A 50-year-old patient complaining of epigastric Pain with recent history of hospitalisation for acute pancreatitis 3 weeks ago.

What is amylase and what is its function?

Group of proteins (digestive enzymes) found in saliva and pancreatic juice
All are glycoside hydrolases and act on a 1,4-glygoside bond to convert starch into smaller carbohydrate molecules (oligosaccharides and disaccharides)

What is CRP and from where it is produced?

C-reactive protein (CRP) is a substance produced by the liver (hepatocytes) early in response to inflammation (acute phase reactant)
Not specific, and can be helpful in monitoring of the progress.

What blood tests to do for pancreatitis?

Serum amylase
Serum lipase (preferred over the amylase due to higher sensitivity)
CRP
FBC

What biochemical tests to be done?

Electrolytes
BG
Ca²⁺
Albumin

Patient is having a compression over the stomach (epigastric fullness, dyspepsia and vomiting), what is the cause?

Pancreatic Pseudocyst

What non-bacterial organisms can cause infection in this patient?

Viruses (e.g. Mumps, Coxsackie Band hepatitis)
Parasites (e.g. ascaris lumbricoides, fascia/a hepatica, and hydatid disease)

Patient Hb dropped why?

Rupture of splenic artery (GDA, PDA) pseudoaneurysm
Haemorrhage

What are the definitive treatment options to stop bleeding?

Surgical
Non-surgical

Elaborate
What is the non-surgical (less invasive) option to stop the bleeding?

Interventional radiology by coiling

How does it work?

Using real-time imaging, the physician guides a catheter through the artery and then releases clotting agents (coils, particles, gel, or foam) into the blood vessel
This will cause slowing the blood flow and causing an internal injury to activate the coagulation cascade.

Which part of the coagulation cascade will be activated?

Intrinsic pathway

What factors is involved in intrinsic pathway?

Factors XII, XI, IX and X
See Pancreatitis station in critical care

isurg

Mock35 Acute Pancreatitis