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VET377 > Lecture 30 - Liver 5 > Flashcards

Lecture 30 - Liver 5 Flashcards

1
Q

Name the structures that are shown in the image below:

A
  1. Ganglion
  2. Blood vessels
  3. Islets of Langerhans
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2
Q

Name the structure below and state what species you would expected to find it in:

A

Pancinian Corpuscle

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3
Q

Name the species that the pancreas below came from:

A

Came from a cat

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4
Q

What form is pancreatic amylase secreted in an what co-factor does it require?

A

secreted in active form - requires Ca2+ as a co-factor

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5
Q

What form is pancreatic lipase secreted in and how is it catalysed?

A

active form - requires Ca2+, colipase and bile salts as co-factors

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6
Q

How are the pancreatic proteolytic enzymes activated?

A

secreted as proenzymes (zymogens) - activated by trypsin and enterokinase in the duodenum

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7
Q

What are the three broad mechanisms of pancreatic damage?

A
  1. Obstruction of the duct
  2. Direct injury to acinar cells
  3. Disturbances of enzyme trafficking within cytoplasm of acinar cells
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8
Q

What are the events involved in pancreatic autolysis?

A
  1. Trypsinogen to trypsin
  2. Activated proelasatase and phospholipase –> digests pancreatic tissue
  3. Trypsin activates the kinin, complement and clotting cascades
  4. Process is amplified –> thrombosis –> haemorrhage –> inflammation
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9
Q

What animals is acute pancreatitis most common in?

A

obese, sedentry, middle aged female dogs

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10
Q

What are the potential sequalae of acute pancreatitis?

A
  1. Haemorrhage, DIC, multi-organ failure and death
  2. Release of myocardial depressent factor
  3. Liver often secondarily affected (by cholestasis)
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11
Q

What is the name of the process that is shown below?

A

Acute pancreatitis

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12
Q

What are two potential complications that can arise from chronic pancreatitis?

A

If significant portion of pancreas is involved:

  • Exocrine pancreatic insufficiency
  • Diabeties mellitus
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13
Q

Name the process that is occuring below:

A

Chronic pancreatitis

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14
Q

What is the result of exocrine pancreatic insufficiency?

A
  • Maldigestion + malabsorption
  • +/- diabeties mellitus
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15
Q

Provide an example of a clinical sign that may be seen with exocrine pancreatic insufficency:

A
  • Diarrhoea + weight loss
  • Flatulence and marked borborygymus
  • Pale, soft malodorous faeces
  • Concurrent SIBO
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16
Q

Name the process that is occuring in the image below:

A

pancreatic atrophy

17
Q

Why must serum amalyse be interpreted with care and what does a very high level mean?

A
  • Also released by liver, pancreas and small intestine
  • Higher level means > chance comming from pancreas
18
Q

What are the sources that contribute to total lipase and what does a higher level indicate?

A
  • Pancreas and gastric mucosa are the only two main sources
  • The greater the increase the more likely it is to be pancreatitis
19
Q

How does DGGR lipase work, what is the sensitivity and specificity like and what species can it be used in?

A
  • Uses novel substrate and it is more specific for pancreatic lipase (and same day turnaround!)
  • Very high sensitivity and specificity
  • Useful in dogs and cats
20
Q

What is the test is available for specifically testing pancreatic lipase in serum? These test have a long turn around time what is an alternative?

A

Pancreatic specific lipase immunoreactivity (PLI) and pancreatic specific lipase (Spec cPL/fPL)

Alternative is to use a snap ELISA test - one for canine and one for feline - they determine quantitative levels

21
Q

What is the best diagnostic imaging modality to use in cases of pancreatitis?

A

Ultrasound is the DI method of choice

22
Q

Is a high fat diet implicated in pancreatitis in cats?

A

NOOOOO NO NO NO NOOOOOO!

23
Q

What is TAP and is it specific for pancreatitis?

A

Trypsin activation peptide (TAP) and is found in urine and serum - quite poorly specific for pancreatitis

24
Q

Rate the following tests in terms of usefulness for detecting pancreatitis in cats: serum amylase, total lipase, DGGR lipase, fPL, fPLI, SNAP fPL

A

Serum amylase + total lipase = not very useful

DGGR lipase, fPL, fPLI, SNAP fPL = good

25
Q

How do urea and creatinine levels appear in cats with pancreatitis and what further steps may need to be taken?

A

Pancreatitis in cats = urea and creatinine increase (azotaemia)

26
Q

What does trypsin like immunoreactivity (TLI) detect and what effect will exocrine pancreatic insufficiency have on it?

A

detects serum trypsinogen, trypsin and tryspin molecules bound to protease inhibitors. Decreased with EPI

27
Q

Name the condition that is shown below:

A

Exocrine pancreatic carcinoma

28
Q

Name the condition that is shown below:

A

Pancreatoliths

VET377 (60 decks)

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