Week 3 Pre-Learning: Disorders of the Pancreas

Question 1

What is acute pancreatitis? (2)

Answer 1

• Acute inflammation of the pancreas
• Abnormal activation of digestive enzymes within the pancreas

Question 2

What are the main causes of acute pancreatitis? (8)

Answer 2

• Gallbladder stones
• Alcohol use
• genetics
• Medications
• Viruses
• Hypercalcemia
• high triglyceride levels
• trauma/procedures

Question 3

What processes occur in the pancreas? (3)

Answer 3

1. Lipolysis
2. Proteolysis
3. Necrosis of blood vessels

Question 4

What is lipolysis?

Answer 4

• Lipase causes fat necrosis of pancreatic cells

Question 5

What is proteolysis?

Answer 5

• Break down of proteins can lead to thrombosis and gangrene

Question 6

What is necrosis of blood vessels? (3)

Answer 6

• Enzymes will dissolve elastic fibers of the pancreatic blood vessels, causing bleeding
• release of more enzymes that cause vasodilation and increased vascular permeability
• Inflammatory mediators –> damage will lead to leukocytes

Question 7

Where would pain be felt with acute pancreatitis? (3)

Answer 7

• left upper quadrant
• mid epigastric area
• radiates to the back, left flank, or left shoulder

Question 8

What are the clinical manifestations of acute pancreatitis? (9)

Answer 8

1. N + V - Inflammation leads to abdominal distention and slowed GI motility
2. Jaundice (swelling of head of pancreas)
3. Hemorrhage
   - break down of blood levels
4. Fever - inflammation
5. Pancreatic enzymes in the blood
   - increased serum amylase and lipase
6. Hyperglycemia
7. Hypovolemia
8. Pulmonary complications
9. Hyperkalemia

Question 9

Why does acute pancreatitis cause an increase in serum amylase and lipase?

Answer 9

When cells die, they release their contents

Question 10

Why does hypocalcemia occur with acute pancreatitis?

Answer 10

• breakdown of fats releases free fatty acids that bind to calcium in blood, causing low serum calcium

Question 11

Why does hyperglycemia occur in acute pancreatitis?

Answer 11

destruction of beta cells,

Question 12

Why does hypovolemia occur in acute pancreatitis? (3)

Answer 12

• increased permeability
• vasodilation
• loss of fluid from vascular space

Question 13

Why do pulmonary complications occur in acute pancreatitis?

Answer 13

• Inflammatory cytokines and enzymes in the blood stream cause inflammation of lungs and alveoli

Question 14

Why does hyperkalemia occur in acute pancreatitis?

Answer 14

• cells/tissue death leads to release of intracellular potassium into the blood stream, causing elevated serum potassium levels

Question 15

In the video, why can patients with acute pancreatitis develop ARDs (acute respiratory distress syndrome)? (3)

Answer 15

• Same reason as pulmonary complications occurring
• alveoli are inflamed and fill with fluid
• enzymes destroy surfactant