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Which initial management steps are essential in treating acute pancreatitis?
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Supportive care, fluid resuscitation, pain control, and nutritional support.
What are some of the main mechanisms leading to acinar cell injury in acute pancreatitis?
Duct obstruction, acinar cell injury from alcohol or drugs, trauma, ischemia, and viral infections.
Describe Cullen Sign and Grey Turner Sign.
Cullen Sign: Bluish discoloration around the umbilicus; Grey Turner Sign: Bluish-red discoloration along the flanks.
List the etiologies of acute pancreatitis using the mnemonic GET SMASHED.
Gallstones, Ethanol, Trauma, Steroids, Mumps, Autoimmune Pancreatitis, Scorpion Sting, Hypercalcemia/Hypertriglyceridemia, ERCP, Drugs.
What are some complications associated with severe acute pancreatitis?
Multi-system organ failure, DIC, ARDS, serious cyst formation, and necrotizing pancreatitis.
Define severe acute pancreatitis.
Severe acute pancreatitis involves persistent organ failure that may affect multiple organs.
Which are the major presenting signs and symptoms of acute pancreatitis?
Severe epigastric abdominal pain radiating to the back, nausea, vomiting, fever, tachycardia, and in severe cases, dyspnea and pleural effusions.
Which serum enzyme level is most specific for diagnosing acute pancreatitis?
Elevated serum lipase.
What is the primary process involved in the development of acute pancreatitis?
Acute inflammatory process of the pancreas caused by enzyme leakage leading to autodigestion, further injury, and edema.
What is the recommended management for acute pancreatitis caused by gallstones?
Cholecystectomy.
How is mild acute pancreatitis classified?
Mild acute pancreatitis is classified by the absence of organ failure or local/systemic complications.
What criteria define moderately severe acute pancreatitis?
Moderately severe acute pancreatitis is defined by transient organ failure resolving within 48 hours or local/systemic complications without persistent organ failure.
What distinguishes the gross findings in acute pancreatitis?
Gross findings include red-black hemorrhagic areas with foci of yellow-white chalky fat necrosis.
What imaging findings are characteristic of acute pancreatitis on a CT scan?
Focal or diffuse pancreatic enlargement, heterogeneous enhancement, and peri-pancreatic fat stranding.
How should fluid replacement be managed in acute pancreatitis?
Fluid replacement should be administered within the first 12-24 hours to reduce morbidity and mortality.
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