Patho/Pharm II Week 5 Key Points: Lower GI, Hepatobiliary, and IBD: Key Pathophysiology and Management

What is acute pancreatitis?

Inflammation caused by premature activation of pancreatic enzymes inside the pancreas.

What triggers autodigestion in acute pancreatitis?

Trypsin activation is the key initiating event.

What are the most common causes of acute pancreatitis?

Gallstones and alcohol.

How does alcohol contribute to acute pancreatitis?

It increases enzyme secretion and causes direct acinar cell injury.

What are the consequences of autodigestion in acute pancreatitis?

Edema, necrosis, hemorrhage, and fat necrosis.

What enzyme breaks down fat in acute pancreatitis?

Lipase.

What is a classic presentation of acute pancreatitis?

Severe epigastric pain radiating to the back.

What is the priority management for acute pancreatitis?

Pancreatic rest (NPO status) to reduce pancreatic stimulation.

What is pancrelipase used for?

It is pancreatic enzyme replacement therapy for chronic pancreatitis with exocrine insufficiency.

What is the role of octreotide in pancreatitis?

It reduces pancreatic enzyme secretion and may be used in severe or refractory cases.

What is hepatitis?

Inflammation of the liver leading to hepatocellular injury and impaired metabolism.

What are the common laboratory findings in hepatitis?

Elevated AST and ALT reflect liver cell injury.

How is hepatitis A transmitted?

Fecal-oral route and is typically acute and self-limited.

What is cirrhosis?

Irreversible fibrosis that replaces normal liver tissue and disrupts blood flow.

What is the consequence of hepatic encephalopathy?

Accumulation of ammonia causing confusion, asterixis, lethargy, and potentially coma.

What is cholelithiasis?

Formation of gallstones within the gallbladder.

What characterizes cholecystitis?

Inflammation of the gallbladder caused by persistent obstruction of the cystic duct.

What is the primary treatment for small cholesterol gallstones in non-surgical candidates?

Ursodiol, which reduces hepatic cholesterol secretion.

What distinguishes ulcerative colitis from Crohn's disease?

Ulcerative colitis involves continuous inflammation limited to the colon, while Crohn's disease has patchy, transmural inflammation.

What is the role of corticosteroids in inflammatory bowel disease?

They suppress the inflammatory response and are effective for inducing remission during acute flares.

What are biologic agents used for in IBD?

They target specific components of the immune response to maintain control over inflammation.

What is the significance of monitoring glucose in chronic pancreatitis?

Endocrine function may be impaired, leading to potential diabetes.

What is the goal of lactulose treatment in hepatic encephalopathy?

To trap ammonia in the gut and promote its excretion through osmotic diarrhea.

What is the typical presentation of biliary colic?

Steady right upper quadrant pain that may radiate to the right shoulder or back, often after fatty meals.

What is the risk associated with untreated cholecystitis?

Can lead to perforation, abscess, or sepsis.

What is the main complication of chronic pancreatitis?

Fibrosis and permanent damage leading to exocrine insufficiency.

What is the typical management for severe pain in acute pancreatitis?

Opioids are often required for pain management.

What is the importance of monitoring for electrolyte abnormalities in acute pancreatitis?

To prevent complications such as hypovolemia and shock.