GIT Journal club acute pancreatitis ACG Practice guidelines with BO4.

1. Prepared by:
Dr.Mohamed Al-Shekhani.

2. Diagnosis:

3. Etiology:

4. Etiology:

16. DIAGNOSIS:

17. Etiology:

18. Initial management:

19. ERCP in AP:

20. Antibiotics in AP:

21. Nutrition in AP:

22. Surgery in AP:

23. 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

24. 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

25. 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.

26. 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.

27. 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.

28. 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.

29. 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

30. 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?

31. 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

32. 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

33. 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.

34. 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.

35. BO4Qs7:
• 3. The preferred fluid replacement therapy in
AP is?
• A. Normal saline.
• B. Glucose saline.
• C. Colloides.
• D. Ringer lactate.
• E. Albumin.

36. BO4Qs7:
• 3. The preferred fluid replacement therapy in
AP is?
• A. Normal saline.
• B. Glucose saline.
• C. Colloides.
• D. Ringer lactate.
• E. Albumin.

37. 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.

38. 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.

39. 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.

40. 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.

41. 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.

42. 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.

43. 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.

44. 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.