patho II test 3

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tab
ID:
181839
Filename:
patho II test 3
Updated:
2012-11-06 20:15:22
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pancreatitis
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Description:
test 3 pancreatitis
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  1. what 2 items from pmh were of relavence for pancreatitis
    • prior cholecystectomy
    • hepatitis C positive (5yrs)
  2. family and social history risk
    heavy alcohol use (10-12 cans of beer/day for 15 yrs)
  3. in pancreatitis what 4 vital signs were abnormal and which way
    • BP - low 85/60
    • HR - high 120
    • RR - high 35
    • Temp - high 101.4
  4. 4 points of significance on physical examination
    • slightly diminished pulses in all extremities
    • diaphoretic
    • guarding
    • rebound tenderness
  5. 2 major functions of the pancreas
    • produce digestive enzymes and juices (trypsin, chymotrypsin, lipase and amylase) produced in exocrine cells
    • secretes insulin, glucagon, and somatostatin into the bloodstream, produced in the endocrine cells
  6. which ethnic group is at risk of developing AP
    african americans 10X
  7. approximately how many cases of pancreatitiis occur nationally every year
    80000
  8. most common cause of AP in the U.S.
    long term alcohol abuse
  9. significant point of examination for the heart
    sinus tachycardia
  10. significant point of examination for th skin
    • dry with poor skin tugor
    • some tenting
    • above 2 indicate elevated specific gravity
    • (-) grey turner sign
    • (-) cullen sign
    • above 2 suggest no retroperitoneal hemorrhaging
  11. 2 points in the patient that were significant for having pancreatitis
    • acute renal failure
    • hypotensive shock
  12. 5 risk factors the patient had for AP
    • long term alcohol use
    • gallstones
    • serum triglycerides > 1000mg/dl
    • surgery, especially abdomen(cholecystectomy)
    • hepatitis C
  13. generalized S&S of AP
    • sweating
    • anxiety
    • patient looks and feels sick
    • hypotension
    • pallor
    • cool, clammy skin
    • upper abdominal pain radiating into the back
    • N/V
    • Fever
    • elevated HR
  14. 7 abnormal lab tests
    • elevated serum amylase and lipase
    • elevated BUN and serum creatinine
    • elevated serum alkaline phosphatase
    • hyperglycemia
    • leukocytosis
    • glycosuria¬†
    • abnormal coagulation tests
    • low serum calcium
  15. 2 causative factors for pancreatic damage
    • obstruction
    • alcohol
  16. three mechanisms by which alcohol causes damage
    • causes premature activation and relaease of the digestive enzymes
    • increases the permeability of the pancreatic duct
    • increases the protein in the pancreatic juices and then decreases bicarbonate and trypsin inhibitors
  17. 6 significant high lab levels
    • BUN - 34
    • glucose - 415
    • Cr - 1.5
    • WBC - 16,400/mm3
    • all liver stuff except T bilirubin(normal) & albumin (low)
    • triglycerides - 971
  18. significant low lab value
    lymphocyte
  19. 2 significan normals for the abdominal ultrasound
    • non specific gas pattern
    • no regions of dilated bowel
  20. 5 tx goals
    • relieve abdominal pain and nausea
    • fluid and electrolyte replacement
    • control glucose and lipid levels
    • minimize systemic complications
    • prevent pancreatic necrosis and infection
  21. how many ranson criteria were present
    6 with a 40% mortality

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