Pancreatitis
Exudates: tuberculosis, pneumonia (parapneumonic effusion or empyema), malignancy, pulmonary embolism, rheumatoid arthritis, lupus, pancreatitis.
What our notes say
- Exudates: tuberculosis, pneumonia (parapneumonic effusion or empyema), malignancy, pulmonary embolism, rheumatoid arthritis, lupus, pancreatitis. (Internal Medicine Respiratory CAT 1: 30 MCQs and 5 short answer questions)
- Topics tested: HIV and the gut, diarrhoea (infectious and non-infectious), alcoholic liver disease, hepatitis A, B and C, cirrhosis, liver tumours, cholera, shigella, gallstones and pancreatitis. (Internal Medicine CAT 1 (MBIM 6112), 2019/2020: gastroenterology and hepatology,)
- Discuss the early management of acute pancreatitis (8 marks) (Internal Medicine CAT 1 (MBIM 6112), 2019/2020: gastroenterology and hepatology,)
- Topics tested: jaundice and liver tests, alcoholic liver disease, hepatitis B and C, primary biliary cirrhosis, NASH, Child-Pugh score, GI bleeding, acute pancreatitis, bone marrow failure, haemophilia and myelodysplasia. (Internal Medicine CAT 1 (MBChB 4), 2022: liver, pancreas and bone marrow, 30 MCQ)
- Acute pancreatitis typically gives a sentinel loop or colon cut-off sign. (Internal Medicine CAT 1 (MBChB 4), 2022: liver, pancreas and bone marrow, 30 MCQ)
- Exudates: tuberculosis, pneumonia (parapneumonic effusion, empyema), malignancy (lung, breast, lymphoma, mesothelioma), pulmonary embolism, rheumatoid arthritis and lupus, pancreatitis, asbestos exposure, drugs, chylothorax and haemothorax. (Junior Clerkship in Internal Medicine (MBIM4100) main exam, Paper One: 31 Januar)
Study material on Pancreatitis
- Internal Medicine 4th Year 1st Semester CAT: HIV and the gut, liver disease and pancreatitis, 30 MCQs and 2 short answers
- Pancreatic Disorders: A Comprehensive Review
- CRUSH COURSE (PART 2) Clinical Chem Patho
- Internal Medicine CAT 1 (MBChB 4), 2022: liver, pancreas and bone marrow, 30 MCQs and 2 short answers
- Clinical Enzymes: Functions and Applications
- Liver Histology & Physiology
- Liver Histology & Physiology
- Internal Medicine CAT 1 (MBIM 6112), 2019/2020: gastroenterology and hepatology, 30 MCQs and 4 short answers
- Gastrointestinal and liver
- Clinical Enzymology and Biomarkers
- MCQ: Gastrointestinal Pathology
- Weekly Pathology Exam - March 7, 2026 (Section A: MCQs)
- Pancreatic Disorders: A Comprehensive Review
- Pancreatic Disorders: A Comprehensive Review
- CLINICAL BIOCHEMISTRY MCQs
- MCQ: GASTROINTESTINAL PATHOLOGY — 60 MCQs (Redistributed Answers)
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Practice questions on Pancreatitis
A patient develops acute pancreatitis. Areas of fat necrosis in the peritoneum appear as chalky-white deposits. This appearance is due to:
- Deposition of fibrin from vascular injury
- Accumulation of cholesterol crystals
- Formation of calcium soaps (saponification)
- Infiltration by neutrophils with myeloperoxidase
Answer: C. In fat necrosis, pancreatic lipases break down triglycerides to fatty acids, which combine with calcium to form calcium soaps—visible as chalky-white areas. This is saponification. This type of necrosis is specific to enzymatic fat breakdown, distinguishing it from other forms. ---
In acute pancreatitis, which histological finding distinguishes it from chronic pancreatitis?
- Extensive parenchymal fibrosis
- Neutrophilic inflammation and enzymatic fat necrosis
- Atrophy of acini
- Ductal squamous metaplasia
Answer: B. Acute pancreatitis is characterized by edema, proteolysis, fat necrosis, and acute inflammation (neutrophils). Chronic pancreatitis is defined by irreversible fibrosis and atrophy. ---
A patient with chronic pancreatitis develops steatorrhea. What is the underlying mechanism?
- Excessive bile acid production
- Loss of >90% of exocrine pancreatic function
- Insulin resistance
- Bacterial overgrowth in the ileum
Answer: B. Steatorrhea and malabsorption occur only when exocrine secretion (lipase, etc.) falls below 10% of normal levels due to parenchymal destruction. ---
A 45-year-old male with chronic pancreatitis experiences steatorrhea (fatty stools) and weight loss. What is the most likely cause of these symptoms?
- Malabsorption due to exocrine pancreatic insufficiency
- Bacterial overgrowth in the small intestine
- Celiac disease
- Short bowel syndrome
Answer: A. Chronic pancreatitis leads to destruction of the exocrine pancreas, impairing the production of digestive enzymes. This results in malabsorption of fats, proteins, and carbohydrates, leading to steatorrhea and weight loss. ---
A 60-year-old male presents with painless jaundice, dark urine, and pale stools. He has a history of chronic pancreatitis. Which diagnostic modality is most likely to identify the cause of his jaundice?
- Abdominal ultrasound
- CT scan of the abdomen
- Endoscopic retrograde cholangiopancreatography (ERCP)
- Liver biopsy
Answer: C. Given the history of chronic pancreatitis, a pancreatic head mass causing biliary obstruction is highly suspected. ERCP allows for visualization and potential intervention (like stenting) of the biliary tree and can also identify pancreatic ductal abnormalities. ---
Which lipid is most closely associated with pancreatitis?
- LDL
- HDL
- Triglycerides
- Total cholesterol Correct
Answer: C. Severe hypertriglyceridemia (>1000 mg/dL) can cause acute pancreatitis through pancreatic lipase activation. ---