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Anatomy of the abdominal viscera: Kidneys, ureters and suprarenal glands
Renal system anatomy and physiology
Renal failure: Pathology review
Anatomy clinical correlates: Anterior and posterior abdominal wall
Anatomy clinical correlates: Inguinal region
Anatomy clinical correlates: Peritoneum and diaphragm
Anatomy clinical correlates: Viscera of the gastrointestinal tract
Anatomy clinical correlates: Other abdominal organs
Appendicitis: Pathology review
Complications during pregnancy: Pathology review
Diverticular disease: Pathology review
Gallbladder disorders: Pathology review
GERD, peptic ulcers, gastritis, and stomach cancer: Pathology review
Inflammatory bowel disease: Pathology review
Mood disorders: Pathology review
Pancreatitis: Pathology review
Anatomy clinical correlates: Female pelvis and perineum
Cervical cancer: Pathology review
Uterine disorders: Pathology review
Extrinsic hemolytic normocytic anemia: Pathology review
Intrinsic hemolytic normocytic anemia: Pathology review
Macrocytic anemia: Pathology review
Microcytic anemia: Pathology review
Non-hemolytic normocytic anemia: Pathology review
Anatomy clinical correlates: Heart
Anatomy clinical correlates: Mediastinum
Anatomy clinical correlates: Pleura and lungs
Anatomy clinical correlates: Thoracic wall
Aortic dissections and aneurysms: Pathology review
Coronary artery disease: Pathology review
Deep vein thrombosis and pulmonary embolism: Pathology review
Pleural effusion, pneumothorax, hemothorax and atelectasis: Pathology review
ECG cardiac infarction and ischemia
Pigmentation skin disorders: Pathology review
Skin cancer: Pathology review
Papulosquamous and inflammatory skin disorders: Pathology review
Anatomy of the abdominal viscera: Esophagus and stomach
Anatomy of the abdominal viscera: Large intestine
Anatomy of the abdominal viscera: Small intestine
Anatomy of the gastrointestinal organs of the pelvis and perineum
Gastrointestinal system anatomy and physiology
Enteric nervous system
Colorectal polyps and cancer: Pathology review
Laxatives and cathartics
Lung cancer and mesothelioma: Pathology review
Nasal, oral and pharyngeal diseases: Pathology review
Obstructive lung diseases: Pathology review
Pneumonia: Pathology review
Tuberculosis: Pathology review
Amnesia, dissociative disorders and delirium: Pathology review
Cerebral vascular disease: Pathology review
Dementia: Pathology review
Electrolyte disturbances: Pathology review
Hypothyroidism: Pathology review
Bile secretion and enterohepatic circulation
Malabsorption syndromes: Pathology review
Bacillus cereus (Food poisoning)
Clostridium difficile (Pseudomembranous colitis)
Vibrio cholerae (Cholera)
Anatomy clinical correlates: Facial (CN VII) and vestibulocochlear (CN VIII) nerves
Cardiomyopathies: Pathology review
Heart blocks: Pathology review
Supraventricular arrhythmias: Pathology review
Valvular heart disease: Pathology review
Ventricular arrhythmias: Pathology review
Vertigo: Pathology review
ECG cardiac hypertrophy and enlargement
ECG normal sinus rhythm
ECG QRS transition
ECG rate and rhythm
Kidney stones: Pathology review
Sexually transmitted infections: Vaginitis and cervicitis: Pathology review
Sexually transmitted infections: Warts and ulcers: Pathology review
Urinary tract infections: Pathology review
Central nervous system infections: Pathology review
Shock: Pathology review
Anatomy clinical correlates: Anterior blood supply to the brain
Anatomy clinical correlates: Temporal regions, oral cavity and nose
Headaches: Pathology review
Traumatic brain injury: Pathology review
Vasculitis: Pathology review
Anatomy clinical correlates: Arm, elbow and forearm
Anatomy clinical correlates: Axilla
Anatomy clinical correlates: Bones, fascia and muscles of the neck
Anatomy clinical correlates: Bones, joints and muscles of the back
Anatomy clinical correlates: Clavicle and shoulder
Anatomy clinical correlates: Foot
Anatomy clinical correlates: Hip, gluteal region and thigh
Anatomy clinical correlates: Knee
Anatomy clinical correlates: Leg and ankle
Anatomy clinical correlates: Median, ulnar and radial nerves
Anatomy clinical correlates: Wrist and hand
Seronegative and septic arthritis: Pathology review
Apnea, hypoventilation and pulmonary hypertension: Pathology review
Heart failure: Pathology review
Nephrotic syndromes: Pathology review
Anatomy clinical correlates: Vertebral canal
Back pain: Pathology review
Anatomy clinical correlates: Male pelvis and perineum
Penile conditions: Pathology review
Prostate disorders and cancer: Pathology review
Testicular and scrotal conditions: Pathology review
Testicular tumors: Pathology review
Anatomy clinical correlates: Eye
Eye conditions: Inflammation, infections and trauma: Pathology review
Eye conditions: Refractive errors, lens disorders and glaucoma: Pathology review
Eye conditions: Retinal disorders: Pathology review
Bronchodilators: Beta 2-agonists and muscarinic antagonists
Bronchodilators: Leukotriene antagonists and methylxanthines
Pulmonary corticosteroids and mast cell inhibitors
Anatomy clinical correlates: Ear
Vaginal and vulvar disorders: Pathology review
Anxiety disorders, phobias and stress-related disorders: Pathology Review
Atherosclerosis and arteriosclerosis: Pathology review
Bone disorders: Pathology review
Diabetes mellitus: Pathology review
Drug misuse, intoxication and withdrawal: Alcohol: Pathology review
Drug misuse, intoxication and withdrawal: Hallucinogens: Pathology review
Drug misuse, intoxication and withdrawal: Other depressants: Pathology review
Drug misuse, intoxication and withdrawal: Stimulants: Pathology review
Dyslipidemias: Pathology review
Hypertension: Pathology review
Movement disorders: Pathology review
Peripheral artery disease: Pathology review
Psychological sleep disorders: Pathology review
Rheumatoid arthritis and osteoarthritis: Pathology review
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Acute Pancreatitis Assessment
Acute Pancreatitis Causes
Acute Pancreatitis Disease
Acute Pancreatitis Interventions
While in the Emergency Department, two individuals came in with severe epigastric pain. Michael who is 45, complains of pain that radiates to his back, vomiting, and nausea.
All of these symptoms appeared after he came home from partying at the bar a few hours ago.
On the clinical examination, there’s epigastric tenderness without guarding or rebound, decreased bowel sounds, and purple discoloration around the periumbilical region. He also tends to bend over to relieve the pain.
Anna, who is 29 years old, on the other hand, says the pain started abruptly and that it doesn’t radiate anywhere. She also noticed it gets worse after her meals. On examination, she presents with epigastric pain, scleral icterus, and fever.
Both were admitted and started on IV fluids.
Blood tests were ordered, which revealed lipase and amylase levels that were 3 times more than normal.
Ok, so from what we can gather, both people have acute pancreatitis.
Let’s begin with a bit of physiology. The pancreas is located in the epigastric region, behind the stomach, and it is mostly a retroperitoneal organ.
It has both endocrine functions, by releasing hormones like insulin and glucagon, and exocrine functions by secreting enzymes needed for food digestion.
The exocrine pancreas releases digestive enzymes through smaller ducts which drain in the main pancreatic duct.
The main pancreatic duct, which travels through the length of the pancreas, joins the common bile duct at the ampulla of Vater and drains into the duodenum.
Now, the main pancreatic enzymes include pancreatic amylase which breaks down carbohydrates; trypsin and chymotrypsin, which break down proteins; and lipase which breaks down lipids.
To protect the pancreas from destroying itself, the acinar cells of the pancreas manufacture zymogen, or the inactive form, of trypsin, called trypsinogen.
Pancreatitis refers to inflammation of the pancreas, an organ located behind the stomach that produces hormones and enzymes that help the body digest food. Pancreatitis can be acute or chronic.
Acute pancreatitis occurs when there is a sudden and severe inflammation, which usually resolves within a few days with proper treatment. It is commonly caused by gallstones and alcohol, and typically presents with epigastric pain that radiates to the back, nausea, vomiting, and decreased bowel sounds.
Chronic pancreatitis occurs when there is a long-term inflammation that can cause permanent damage to the pancreas and lead to serious complications. It is usually due to long-term alcohol use, genetic diseases like SPINK1 mutations and cystic fibrosis, pancreatic duct obstruction due to tumors, and autoimmune conditions.
People with chronic pancreatitis may be initially asymptomatic for a long time, but they might develop epigastric pain that radiates to the back, steatorrhea, fat-soluble vitamin deficiency like vitamin A, D, or E; diabetes, and unintentional weight loss.
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