Hurst – Gastrointestinal Questions and Answers Already Passed

Hurst – Gastrointestinal Questions and Answers Already Passed What is pancreatitis Auto-digestion of the pancreas What are the two separate functions of the pancreas? Endocrine - insulin Exocrine - digestive enzymes What are the two types of pancreatitis 1. Acute: #1 Cause = Alcohol #2 Cause = Gallbaldder Disease 2. Chronic: #1 Cause = Alcohol Parts of the pancreas a. Pancreatic Duct - travels through pancreas b. Digestive Enzymes - Inactive while in pancreas until they get to the small intestines c. Scar Tissue - forms in pancreatic duct by alcoholism which causes scar tissue and occludes duct d. Gallstones Enzymes get tired of waiting and activate while in the pancreas - so they start eating the pancreas Note: if any part of the GI system gets sick - other parts of the GI can get sick as well. Blank S/S of Pancreatitis a. #1 Pain - increases with eating b. Abdominal distention/ascites (losing protein rich fluids like enzymes and blood into the abdomen) c. Abdominal mass - swollen pancreas d. Rigid board-like abdomen (guarding or bleeding - developed pancreatitis) e. Bruising around umbilical area known as Cullen's sign Bruising in flank (side) area known as Gray Turner's sign f. Fever (inflammation) g. NV h. Jaundice - liver is involved i. Hypotension = bleeding or ascites What is ascites? Buildup of fluid in the space between the lining of the abdomen and abdominal organs Pancreatitis Lab Values Amylase: 45-200 U/L (dye) *Lipase: 0-110 U/L - most specific to pancreatitis* AST: 8-40 U/L ALT: 10-30 U.L Hemoglobin: 12-18 (male 14-18; female 12-16) Hematocrit: 38-54% (male 40-54%; female 38-47%) What is most specific in diagnosing pancreatitis? Lipase Dx: Serum lipase and amylase are.... Digestive enzymes and they are not supposed to be in the blood stream Dx: WBC's Blood sugar ALT, AST-liver enzymes PT, PTT Serium bilirubin H/H (hemoglobin & hematocrit) Dx: WBC's - elevated Blood sugar - elevated - could be a diabetic forever now ALT, AST - liver enzymes - elevated - if liver is messed up, #1 thing to worry about is bleeding PT, PTT - longer - for blood to clot