Pancreatitis patho

Comprehensive vocabulary review flashcards covering the etiology, cellular pathophysiology, clinical manifestations, complications, and pharmacological management of acute and chronic pancreatitis based on NUR 431 lecture notes.

Pancreatitis

Inflammation of the pancreas caused by the autodigestion of pancreatic parenchyma and tissues by its own prematurely activated digestive enzymes.

Acute Pancreatitis

A sudden onset of typically reversible pancreatic inflammation, presenting primarily with acute epigastric pain that frequently radiates to the back and is associated with elevated serum amylase and lipase levels.

Chronic Pancreatitis

A long-term, progressive inflammatory condition persisting over weeks to months that leads to permanent structural damage, parenchymal destruction, fibrosis, and loss of endocrine and exocrine function.

Autodigestion

The pathological process wherein digestive enzymes, such as trypsin and pancreatic lipase, are prematurely activated inside the pancreatic tissue rather than the duodenum, resulting in self-destruction, inflammation, and vascular damage.

Biliary Duct Obstruction Pathway

The pathophysiological chain of events—frequently triggered by cholelithiasis—where gallstones obstruct pancreatic fluid outflow, resulting in secretion backup, premature enzyme activation, autodigestion, vascular injury, necrosis, and pseudocyst formation.

Alcohol-Induced Acinar Cell Injury

The mechanism whereby pancreatic acinar cells metabolize ethanol into toxic metabolites, causing cell injury, release of activated digestive enzymes, and local tissue inflammation.

Grey Turner's Sign

Bluish discoloration or ecchymosis located along the flanks, reflecting retroperitoneal hemorrhage and severe necrotizing pancreatitis.

Cullen's Sign

Periumbilical ecchymosis resulting from retroperitoneal hemorrhage tracking through fascial planes to subcutaneous tissues surrounding the umbilicus.

Pancreatic Pseudocyst

A localized fluid collection containing pancreatic enzymes, fluid, and necrotic debris surrounded by a non-epithelial capsule of granulation and fibrous tissue, usually forming weeks after acute pancreatitis.

Pancreatic Abscess

A circumscribed, walled-off purulent cavity within or around the pancreas, caused by bacterial colonization and infection of necrotic pancreatic tissue or a pre-existing pseudocyst.

Fat Necrosis (Saponification)

The breakdown of mesenteric and peripancreatic adipose tissue by released pancreatic lipase, producing free fatty acids that bind with circulating calcium to create insoluble calcium deposits.

Pancreatitis-Induced Hypocalcemia

A decline in serum calcium concentration resulting from the rapid chelation and sequestration of circulating ionized calcium into areas of fat necrosis and saponification within the abdominal cavity.

Tetany

Neuromuscular hyperirritability caused by hypocalcemia and hypomagnesemia, characterized by tingling, numbness, muscle twitching, cramping, and involuntary spasms.

Trousseau's Sign

Carpopedal spasm of the wrist and fingers induced by inflating a blood pressure cuff above systolic pressure for 3 minutes, indicating latent tetany from hypocalcemia.

Chvostek's Sign

Involuntary ipsilateral twitching of the facial muscles provoked by tapping the facial nerve anterior to the ear, reflecting hypocalcemic neuromuscular irritability.

Acute Respiratory Distress Syndrome (ARDS) in Pancreatitis

A severe pulmonary complication where inflammatory mediators and circulating cytokines injure the alveolar-capillary membrane, leading to dyspnea, hypoxemia, and bilateral pulmonary infiltrates.

Pleural Effusion (in Pancreatitis)

The pathological build-up of fluid in the pleural space caused by transdiaphragmatic lymphatic drainage of pancreatic exudate and systemic inflammatory capillary leak, resulting in dyspnea and decreased breath sounds.

Pancreatitis-Associated Hypotension

Low systemic blood pressure (systolic BP $< 90\,\text{mmHg}$) driven by extensive third-space fluid accumulation, vomiting, systemic inflammatory vasodilation, and decreased intravascular volume.

Steatorrhea

The excretion of bulky, pale, greasy, foul-smelling stools due to impaired digestion and absorption of fats resulting from exocrine pancreatic insufficiency and lipase deficiency.

Pancreatogenic Diabetes Mellitus

A form of secondary diabetes resulting from the progressive destruction of insulin-producing pancreatic islet cells by long-standing inflammation and fibrosis.

Chronic Pancreatitis Structural Changes

Pathological alterations characterized by glandular atrophy, chronic release of inflammatory cytokines, progressive fibrous tissue replacement, pancreatic duct dilation, ductal calculi, and parenchymal calcifications.

Morphine

An opioid analgesic administered to achieve central pain relief during severe acute attacks of pancreatitis.

Dicyclomine (Bentyl)

An anticholinergic antispasmodic medication prescribed to suppress gastrointestinal spasms and diminish vagally mediated pancreatic secretions.

Antacids and H2-Receptor Antagonists

Agents that suppress gastric hydrochloric acid ($\text{HCl}$) production, reducing secretin release and subsequent stimulation of pancreatic enzyme secretion to rest the gland.

Pancrelipase (Creon)

An exocrine pancreatic enzyme replacement formulation containing lipase, amylase, and protease, indicated exclusively in chronic pancreatitis and exocrine insufficiency to facilitate nutrient digestion.

Pancrelipase Contraindication: Pork Allergy

A hypersensitivity warning indicating that pancrelipase must not be administered to patients with documented allergies to pig products or pork proteins, from which the medication is derived.

Pancrelipase Administration Timing

The clinical requirement that pancreatic enzyme capsules must be administered immediately before or concurrently with all meals and snacks to effectively facilitate fat and nutrient absorption.