Acute Pancreatitis exam questions for medical finals, OSCEs and MRCP PACES

 

Question 1.

What are the causes of acute pancreatitis?

  • I – Idiopathic (most common)
  • G – Gallstones
  • E – Ethanol
  • T – Trauma
  • S – Steroids
  • M – Mumps
  • A – Autoimmune (eg. PAN)
  • S – Scorpion Venom – black Trinidadian scorpion (tityus trinitatis)
  • H – Hyperlipidaemia, Hypercalcaemia
  • E – ERCP
  • D – Drugs (azathioprine, thiazides, valproate, asparaginase, allopurinol)
  • And Pregnancy

Question 2.

What is the Glasgow scoring system for severity?

Glasgow criteria for predicting severity: PANCREAS mnemonic

  • PaO2 <8Kpa
  • Age < 55yrs
  • Neutrophils (WBC > 15)
  • Calcium <2mmol/L
  • Renal function (Urea > 16)
  • Enzymes (LDH > 600, AST > 200)
  • Albumin < 32g/L
  • Sugar > 10mmol/L

Question 3.

What are the complications of acute pancreatitis?

  • Early:
    • Shock
    • Acute kidney injury
    • Acute respiratory distress syndrome
    • DIC
    • Sepsis
    • Hypocalcaemia
    • Hyperglycaemia
    • Pancreatic necrosis
  • Late:
    • Pancreatic necrosis
    • Pancreatic pseudocyst
    • Pancreatic fluid in lesser sac
      • Fluid in lesser sca
      • Presents > 6 weeks later
      • Abdominal mass may be present
      • May need internal (via stomach) or external drainage
    • Abscess
    • Thrombosis – splenic/gastroduodenal arteries
    • Fistulae