Medicine powerpoints

Jun 29th, 2015
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Kaplan University
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Comprehensive power points in gynecology, internal medicine, psychiatry, pediatrics, etc

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CHRONICPANCREATITIS A 49-year-old man was admitted with a ninemonth history of intermittent attacks of epigastricpain, jaundice and fever. These attacks usually last up to several daysassociated with nausea and vomiting. He was well in between attacks and had no lossof weightWhat is your next step?Lab ResultsAP =1017GGT= 269AST =103ALT =186 TB =2 (DB= 1.1) Alb= 3.2 Lipase =33 (up to 244during attacks) Amylase= 44 Hb =12 WBC= 5.7 Plts= 223Na =141 K =4.2 Ur =15 Cr =0.9 Ca =8.9 FBS:178What are arrows?Pancreatic calcification Transabdominal US: No gallstones ormass in head of pancreas CT scan: The extrahepatic bile duct wasmildly dilated and "generous pancreas"was noted but there was no mass.Endoscopic UltrasoundDiffuse hypoechoic enlargement of pancreas. Fine needleaspirate of the pancreas was negative for tumor.ERCPThere was a long segment of extrahepatic biliary stricture.The pancreatic duct was normal in size but irregular.Brushings, biopsies and bile aspirate were negative fortumorThe patient underwent Whipple'soperationHistology of the pancreasshowed chronic pancreatitis, nomalignancy Two presentation: Episodes of acute inflammation in a previouslyinjured pancreas Chronic damage with persistent pain ormalabsorption Etiology : same as acute pancreatitis pancreatitisassociated with gallstones predaminantly acuteo

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