Sat27November0556PM 14

In acute pancreatitis:

True / False

A 'sentinel loop' may be visible on the abdominal x ray Correct

A necrotic pancreas is an indication for early surgery Correct

Acute pancreatitis may be associated with hyperglycaemia Correct

A poor prognosis may be indicated by a serum urea greater than 10 mmol per litre Correct

The serum calcium is usually high Incorrect answer selected

Explanation

Acute pancreatitis is an auto-digestive process which is commonly associated with biliary tract disease or excessive alcohol intake.

Other recognised causes include:

abdominal trauma

mumps

hypothermia, and

diuretic and steroid therapy.

The classical laboratory findings include:

raised serum amylase

leucocytosis

hyperglycaemia

hypocalcaemia

hypoproteinaemia, and

hyperlipidaemia.

An abdominal x ray may reveal a 'sentinel loop' of small bowel overlying the pancreas. The chest x ray can show a wide range of pathology.

Poor prognosis may be indicated by:

age >55 years

systolic blood pressure <90 mmHg

white cell count >15 × 109/L

temperature >39°C

glucose >10 mmol/L

PaO2 <8 kPa

urea >15 mmol/L

calcium <2 mmol/L

haematocrit reduced by over 0.1

abnormal liver function tests.

Surgery may be required for drainage of an abscess or pseudocyst, but the resection of a necrotic pancreas early in the disease has a high mortality.

Answer Statistics

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Average score: 77.49%

Times answered: 342