2C-"We ate Pancreas!"

Question 1

What does pancreas endocrine function refer to?

Answer 1

Insulin and Glucagon

Question 2

What does pancreas exocrine function refer to?

Answer 2

Pancreatic Juice

Question 3

What are the 2 GENERAL contents of pancreatic juice? What is the pH?

Answer 3

1.HCO3 2.Digestive Enzymes(9)…pH of 7.6 to 8.2-Alkaline to balance stomach acid

Question 4

What are the three anatomical divisions of the pancreas? Which division is closest to the Duodenum?

Answer 4

Tail, Body, and Head (next to Duodenum)

Question 5

What are the two main cell groups of the pancreas? What % composition?

Answer 5

1.Islets of Langerhans (endocrine)-5% 2.Ascinar cells (exocrine cells)-95%

Question 6

How does pancreatic juice travel from the pancreas to the duodenum?

Answer 6

The main pancreatic duct

Question 7

Review: How much Pancreatic Juice is produced per day?

Answer 7

1.5 L

Question 8

What 2 juices, along with pancreatic juice, are neutral or alkaline to bring the Duodenum pH to 6.0-7.0?

Answer 8

Bile and Intestinal Juice

Question 9

What is the INFAMOUS region where the Bile Duct Sphincter, the Pancreatic Duct Sphincter, and the Sphincter of Oddi all join together?

Answer 9

the Papilla of Vater (NOT darth Vader)

Question 10

BOOM: WHAT ARE THE 9, yes NINE, Enzymes of the Pancreatic Juice??!!

Answer 10

1.Pancreatic Amylase 2.Pancreatic Lipase 3.CoLipase 4.Trypsinogen 5.Chymotrypsinogen 6.Procarboxypeptidase (A/B) 7.Pro-Elast-ase 8.RiboNuclease 9.DeOxyRiboNuclease

Question 11

What are the proteases of the pancreatic juice secreted as?

Answer 11

Inactive “pro-enzymes”

Question 12

What converts Trypsinogen to Trypsin? Where does this happen?

Answer 12

EnteroKinase(EnteroPeptidase)..At the entrance of the Duodenum

Question 13

What are the three proteases that Trypsin converts from inactive to active forms?

Answer 13

1.Chymotrypsinogen—>Chymotrypsin 2.ProCarboxyPeptidase—->CarboxyPeptidase 3.Pro-elastase—>Elastase

Question 14

_________ deficiency can occur as a congenital abnormality, which leads to protein malnutrition.

Answer 14

Enterokinase

Question 15

What does Pancreatic tissue keep up its sleeve to keep its enzymes from digesting itself?

Answer 15

Trypsin Inhibitors!

Question 16

What are the two hormones controlling pancreatic juice secretion? What are their products like?

Answer 16

1.Secretin-Pancreatic Juice that’s RICH in HCO3- and LOW in enzymes. 2.CCK-Pancratic Juice that’s Rich in enzymes and Low in HCO3-

Question 17

What CN stimulates secretion of pancreatic juice? How does this juice compare to to Secretin/CCK? What triggers this CN response?

Answer 17

VAGUS X! A juice rich in enzymes, but not as much as CCK. The SIGHT or SMELL of food can trigger this!

Question 18

___________ is a severe, life-threatening disorder associated with the escape of activated pancreatic enzymes into the pancreas and surrounding tissues.

Answer 18

Acute pancreatitis

Question 19

Measurement of the plasma _________ or __________ is therefore of value in diagnosing problems associated with inflammation and necrosis of pancreatic acinar cells.

Answer 19

pancreatic amylase or pancreatic lipase

Question 20

In pancreatitis, these enzymes cause _______, or “_______” of the pancreas and produce fatty deposits in the abdominal cavity with hemorrhage from the necrotic vessels.

Answer 20

fat necrosis or “auto digestion”

Question 21

What are the two main causes for Pancreatitis?

Answer 21

1.Gallstones in the common bile duct 2.EtOH

Question 22

What are the two pancreas results of Alcohol?

Answer 22

1.EtOH is a POTENT pancreatic secretion stimulator 2.Contraction of the Sphincter of Oddi

Question 23

LISTS! What 6 things is Acute Pancreatitis also associated with?

Answer 23

1.HyperLipidEmia 2.HyperParathyroidism 3.Viral Infections 4.Abdominal/Surgical Trauma 5.Drugs-STEROIDS 6.Thiazide Diuretics

Question 24

What is the most common initial symptom of Pancreatitis?

Answer 24

SEVERE Epigastric and Abdominal Pain radiates to the Back that is bad in a SUPINE position!

Question 25

What condition is associated with abdominal distention accompanied by hypoactive (soft) bowel sounds?

Answer 25

Pancreatitis

Question 26

Mild _______ may appear after the first 24 hours because of biliary obstruction in pancreatitis.

Answer 26

jaundice

Question 27

An important disturbance related to acute pancreatitis is the loss of a large _________ into the abdominal cavity.

Answer 27

volume of fluid

Question 28

Tachycardia, hypotension, cool and clammy skin, and fever often are evident in _________.

Answer 28

Acute Pancreatitis

Question 29

Signs of hypocalcemia may develop in acute pancreatitis, probably as a result of the precipitation of serum calcium in the areas of ________.

Answer 29

fat necrosis

Question 30

The commonly used term "pancreatic cancer" usually refers to a _____________ of the pancreas (including its subtypes).

Answer 30

ductal adenocarcinoma

Question 31

More than 95% of malignant neoplasms of the pancreas arise from the ________ elements and are referred to as "____________".

Answer 31

exocrine..."exocrine pancreatic cancers"

Question 32

What are the three most common presenting symptoms in patients with exocrine pancreatic cancer?

Answer 32

1.Pain 2.Jaundace 3.Weight

Question 33

The initial presentation of pancreatic cancer varies according to tumor location. Approximately 60-70% exocrine pancreatic cancers are localized to the ______ of the pancreas, while 20-25% are in the ________ and the remainder involve the whole organ. Compared to tumors in the body and tail of the gland, pancreatic head tumors more often present with _______, ________, and ________.

Answer 33

head.....body/tail.... jaundice, steatorrhea (Fat in stool) (not being digested), and weight loss (no food digested)

Question 34

___________ is the only potentially curative treatment for exocrine pancreatic cancer, but because of the late presentation of the disease, only ______% of patients are candidates for _________.

Answer 34

Surgical resection..15-20% ..pancreatectomy

Question 35

The prognosis of pancreatic cancer is poor. The five-year survival following pancreatico- duodenectomy is only about ______% for node-negative and _____% for node- positive tumors.

Answer 35

25-30%...10% (node positive means trouble)

Question 36

What are the 5 major risk factors for pancreatic cancer?

Answer 36

1.Cigarette Smoking 2.High Body Mass 3.Lack of Physical Activity 4.History of Chronic Pancreatitis 5.Genetic

Question 37

What is the most common LETHAL genetic disease among "whites"?

Answer 37

Cystic Fibrosis

Question 38

Cystic Fibrosis results from a defect in ________ that is caused by a mutation in the _______________(____) gene.

Answer 38

Cl- channels......cystic fibrosis transmembrane conductance regulator (CFTR)

Question 39

Characteristics of Cystic Fibrosis include malfunction of ______ glands, resulting in increased ______ of mucus and increased chloride concentration in _____ and _____.

Answer 39

exocrine....viscosity....sweat and tears

Question 40

What is the most important diagnostic procedure for Cystic Fibrosis?

Answer 40

The sweat test!

Question 41

What are the three clinical manifestations of Cystic Fibrosis?

Answer 41

1.Chronic Pulmonary Disease 2.Pancreatic Insufficiency 3.Meconium Ileus (thick stool blocking the ilium in a baby)