High -Yield Internal Medicine Board Exam Pearls by Knowmedge - HTML preview

3. Pancreas

20 | P a g e

K N O W M E D G E

The prevalence of pancreatitis continues to rise in the Western world, and thus remains

a favorite for the ABIM boards. Although alcohol and gallstones remain the major cause

of acute pancreatitis, metabolic (hyperlipidemia, hypercalcemia), infectious (CMV,

EBV, parasites), and autoimmune causes should be considered.

Remember:

 Diagnosis of acute pancreatitis can be made without imaging, but

contrast-enhanced CT scan is used if there is concern for necrotizing

pancreatitis

 If necrotizing pancreatitis is suspected, prophylactic antibiotics should be

used – imipenem, cephalosporins, and fluoroquinolones

 ERCP is used if there is evidence of gallstone pancreatitis and suspected

biliary obstruction

 Consider a deficiency in fat-soluble vitamins (A, D, E, K) in chronic

pancreatitis

Look for CA 19-9 as a tumor marker for pancreatic cancer. Better yet, be able to

recognize the whole table of important tumor markers discussed in the oncology section

of Knowmedge.