Chronic pancreatitis enzymes

Q . All are true regarding enzyme supplementation in chronic pancreatitis except 

a) Lipase to be given 30000U before or after meal

b) H2 blocker is mandatory with enteric coated tablets

c) Main cause of failure is inadequate dosage

d) In cases of failure of enzyme replacement feeding of medium chain Triglycerides are  helpful


Ans

Indications of enzyme supplementation are -

  1. Weight loss, steatorrhea (15g/day ) or both
  2. Dyspepsia, Diarrhoea, bloating, malabsorption of proteins  and carbohydrates
  3. Pain abdomen

Read on for ans Q 23 

Islet cells

Q  Regarding islet cell of pancreas true is (AIIMS, JIPMER) 

a) Cells in descending order of frequency is B,D,A,F

b) B cells are more common in the periphery of islets

c ) Peri islet acinar cells same as acinar cells else where

d) Portal flow from islet to acinar cell helps to control secretions

Answer 

Pouch design

Q. False statement about pouch design is-

a) S pouch is  preferred when length is  not available

b) J pouch is the  most preferred

c) W pouch has  more chances of diarrhoea than J pouch

d) Volume of the pouch is inverse proportional to the no of bowel movements

Answer 

ERCP in pancreatitis

Q) All are true about ERCP in pancreatitis except

a) Not useful in patient with multiple strictures and stones

b) Ductal stenting associated with changes of c/c pancreatitis in 50%

c) In pts with pancreas divisum minor duct sphincterotomy causes significant pain relief irrespective of size of duct

d) Pain relief with endoscopic intervention occurs irrespective of relief of ductal pressure/ decrease in duct size


Answer for premium members  ( Please log in to see) 

Pancreatic  ductal  obstruction  by  fibrotic  stenoses  and/or  calculi are  the  most  frequent  indications  for  endoscopic  therapy.

Multiple strictures and stones are not amenable for endoscopic therapy ....................