GIT Journal club acute pancreatitis ACG Practice guidelines.

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Prepared by: Dr.Mohamed Al-Shekhani.

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GIT Journal club acute pancreatitis ACG Practice guidelines with BO4.

Transcript of GIT Journal club acute pancreatitis ACG Practice guidelines.

Page 1: GIT Journal club acute pancreatitis ACG Practice guidelines.

Prepared by:Dr.Mohamed Al-Shekhani.

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Diagnosis:

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Etiology:

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Etiology:

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DIAGNOSIS:

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Etiology:

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Initial management:

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ERCP in AP:

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Antibiotics in AP:

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Nutrition in AP:

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Surgery in AP:

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BO4Qs1:

• 1. Which one of the following is a required finding for the diagnosis of acute pancreatitis (AP)?

• A. Severe mid-abdominal pain• B. E levated serum amylase between *1 – 3 ULN.• C. Abnormal appearance of the pancreas on CT

imaging• D. Exclusion of peptic ulcer disease on normal

upper endoscopy

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BO4Qs1:

• 1. Which one of the following is a required finding for the diagnosis of acute pancreatitis (AP)?

• A. Severe mid-abdominal pain• B. E levated serum amylase between *1 – 3 ULN.• C. Abnormal appearance of the pancreas on CT

imaging• D. Exclusion of peptic ulcer disease on normal

upper endoscopy

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BO4Qs2:

• 2. Which one of the following statements is true regarding gallstone-associated AP?

• A. ERCP is contraindicated in patients with AP & cholangitis.

• B. Cholecystectomy should be delayed for 4–6 weeks in patients with AP and gallstones in the gallbladder.

• C. Pancreatic duct stents lower the risk of severe post-ERCP pancreatitis in high-risk patients.

• D. All patients with AP and gallstones should be given antibiotics to prevent the development of pancreatic necrosis.

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BO4Qs2:

• 2. Which one of the following statements is true regarding gallstone-associated AP?

• A. ERCP is contraindicated in patients with AP & cholangitis.

• B. Cholecystectomy should be delayed for 4–6 weeks in patients with AP and gallstones in the gallbladder.

• C. Pancreatic duct stents lower the risk of severe post-ERCP pancreatitis in high-risk patients.

• D. All patients with AP and gallstones should be given antibiotics to prevent the development of pancreatic necrosis.

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BO4Qs3:

• 3. Which one of the following statements is true regarding nutrition in AP?

• A. In mild AP, nasojejunal feeding decreases the risk of progression to more severe AP.

• B. In severe AP, RCTs have clearly shown NJ feeding to be superior to NGT feeding.

• C. Parenteral nutrition is indicated in severe AP.• D. Low-fat solid diets are equal to liquid diets in

mild AP.

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BO4Qs3:

• 3. Which one of the following statements is true regarding nutrition in AP?

• A. In mild AP, nasojejunal feeding decreases the risk of progression to more severe AP.

• B. In severe AP, RCTs have clearly shown NJ feeding to be superior to NGT feeding.

• C. Parenteral nutrition is indicated in severe AP.• D. Low-fat solid diets are equal to liquid diets in

mild AP.

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BO4Qs4:

• 4. Which one of the following quantities is considered the cut-off for small versus large gallstones?

• A. > 5 mm• B. > 8 mm• C. > 10 mm• D. > 12 mm

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BO4Qs4:

• 4. Which one of the following quantities is considered the cut-off for small versus large gallstones?

• A. > 5 mm• B. > 8 mm• C. > 10 mm• D. > 12 mm?

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BO4Qs5:

• 3. Which one of the following is an indication for deep cannulation of the pancreatic duct during ERCP?

• A. Acute biliary pancreatitis• B. Chronic pancreatitis with symptomatic

stricture• C. Sphincter of Oddi manometry• D. Suspected cholangiocarcinoma

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BO4Qs5:

• 3. Which one of the following is an indication for deep cannulation of the pancreatic duct during ERCP?

• A. Acute biliary pancreatitis• B. Chronic pancreatitis with symptomatic

stricture• C. Sphincter of Oddi manometry• D. Suspected cholangiocarcinoma

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BO4Qs6:

• 3. CECT or MRI in AP is indicated in all these situations except ?

• A. As initial evaluation.• B. When the diagnosis is unclear.• C. To evaluate local complications.• D. When is no early clinical improvement.

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BO4Qs6:

• 3. CECT or MRI in AP is indicated in all these situations except ?

• A. As initial evaluation.• B. When the diagnosis is unclear.• C. To evaluate local complications.• D. When is no early clinical improvement.

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BO4Qs7:

• 3. The preferred fluid replacement therapy in AP is?

• A. Normal saline.• B. Glucose saline.• C. Colloides.• D. Ringer lactate.• E. Albumin.

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BO4Qs7:

• 3. The preferred fluid replacement therapy in AP is?

• A. Normal saline.• B. Glucose saline.• C. Colloides.• D. Ringer lactate.• E. Albumin.

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BO4Qs8:

• 3. Severe AP is defined when there is?• A. Local complications.• B. Transient Organ failure.• C. Persistent organ failure.• D. A&C.• E. C.

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BO4Qs8:

• 3. Severe AP is defined when there is?• A. Local complications.• B. Transient Organ failure.• C. Persistent organ failure.• D. A&C.• E. C.

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BO4Qs9:

• 3. In the absence of gall stones & alcohol abuse, hypertriglyceridemia is considered causative of AP is the level is above?

• A. 500.• B. 600.• C. 800.• D. 900.• E. 1000.

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BO4Qs9:

• 3. In the absence of gall stones & alcohol abuse, hypertriglyceridemia is considered causative of AP is the level is above?

• A. 500.• B. 600.• C. 800.• D. 900.• E. 1000.

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BO4Qs10:

• 3. Genetic testing for heriditary AP is indicated when there is family history of pancreatic disease & the age is less than?

• A. 50.• B. 40.• C. 30.• D.50.• E. 20.

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BO4Qs10:

• 3. Genetic testing for heriditary AP is indicated when there is family history of pancreatic disease & the age is less than?

• A. 50.• B. 40.• C. 30.• D.50.• E. 20.

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BO4Qs11:

• 3. The risks & benefits of routine EUS in finding a cause of idiopathic AP are?

• A. Clear.• B. Unclear.• C.Well established.• D. More Risky.• E. None of the above.

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BO4Qs11:

• 3. The risks & benefits of routine EUS in finding a cause of idiopathic AP are?

• A. Clear.• B. Unclear.• C.Well established.• D. More Risky.• E. None of the above.