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WorksheetsPharm - Pancreatitis
Total questions: 15
Worksheet time: 8mins
All of these are causes of acute pancreatitis, but what is the MOST COMMON?
Alcohol use
Hypertriglyceridemia
Gallstones
Autoimmune disease
Hypercalcemia
Pt presents with severe pain in the epigastric/LUQ areas. Pt also reports N/V. Labs show elevated amylase and lipase. What are the nonpharmacologic treatment options? (choose 2)
Surgery
TIPS
ERCP
Balloon tamponade
Pt presents with severe pain in the epigastric/LUQ areas. Pt also reports N/V. Labs show elevated amylase and lipase. What is NOT included in the treatment?
Aggressive IV hydration w/ isotonic crystalloid solution
IV carbapenems (meropenem, imipenem-cilastatin)
NPO for 48 hrs
IV opioid (hydromorphone, morphine, fentanyl)
Which of the following is NOT an appropriate nutritional recommendation for acute pancreatitis?
NPO (gut rest for 48 hrs)
Oral feedings once pain/N/V resolves
Parenteral feedings w/ severe or complicated
Start oral feedings w/ clear liquids, then progress to soft, low-fat foods
Enteral feeding (NG tube) w/ severe or complicated
Pt in the hospital for acute pancreatitis is still not improving after 8 days. They have developed a fever. Labs show increased WBC. You suspect infected necrosis. What is NOT a possible treatment?
Meropenem
Pip-tazo
Cefepime + metronidazole
Ciprofloxacin + metronidazole
Ceftriaxone + Levofloxacin
All of the following are causes of chronic pancreatitis, but what is MOST COMMON?
Idiopathic
Genetics
Chronic alcohol use
Obstruction
Pt who reports to chronic alcohol use presents with weight loss, steatorrhea, abd pain radiating to the back, N/V, fatty food intolerance, and recurring episodes of acute pancreatitis. CT shows pancreatic atrophy, calcifications, and duct dilation. Labs show low serum trypsin and fecal elastase, abnormal fecal fat estimation, secretin stimulation. What is NOT a nonpharmacologic treatment option?
Small, more frequent meals
D/C ETOH and smoking
ERCP
Limit fat
Surgery
What pancreatic function test findings is NOT consistent with chronic pancreatitis?
Low fecal elastase (< 200) mcg/g of stool)
Abnormal fecal fat estimation (> 7 g/day)
Elevated serum trypsin (> 20 mg/dL)
Secretin stimulation
All of the following are pain management options for chronic pancreatitis, but what is the 1st line?
Pregabalin
TCAs
Opioids +/- NSAIDs or acetaminophen
SSRIs
SNRIs
What is the treatment for a malabsorption management when steatorrhea is present in a pt with chronic pancreatitis?
Opioids
IV isotonic crystalloid solution
PERT
TIPS
Which of the following is NOT true about PERT treatment for chronic pancreatitis with steatorrhea?
1/2 dose with each snack
H2RA or PPI is required for non-enteric coated formulations of PERT
Lipase administered during or immediately after meals
Non-enteric coated formulations are preferred
Wait up to 6 weeks before reassessment
What system is used to score severity of pancreatitis?
Ranson Criteria
Revised Atlanta Classification
Child-Pugh
MELD
What system is used to assess organ failure and local/systemic complications of pancreatitis?
Ranson Criteria
Revised Atlanta Classification
Child-Pugh
MELD
Which would be the most appropriate pain management therapy for a pt with acute pancreatitis?
Oxycodone PO
Meperidine IM
Fentanyl transdermal patch
Hydromorphone IV
If a pt presents with severe acute pancreatitis, parenteral nutrition should be initiated as soon as possible.
True
False
