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Clinical Pathology > Lecture 17: Lipids, exocrine pancreas and GI > Flashcards

Lecture 17: Lipids, exocrine pancreas and GI Flashcards

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1
Q

Describe lipid metabolism

A
  1. Dietary lipids digested into monoglycerides and FA and form Micelles that are absorbed
  2. Chylomicrons form in enterocytes and secreted into lymphatics
  3. Chylomicrons enter blood via thoracic duct and are metabolized by hepatocytes, adipocytes
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2
Q

what are the functions of lipoids

A
  1. Energy storage
  2. Main component of cellular membranes
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3
Q

what are the main lipids present in blood

A
  1. LCFA
  2. Triglycerides
  3. Cholesterole
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4
Q

cholesterol and triglycerides are transported in blood attached to __

A

proteins

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5
Q

lipid-protein complexes are called __

A

lipoproteins

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6
Q

lipolysis of lipoproteins are catalyzed by __

A

lipoprotein lipase (LPL)

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7
Q

lipolysis via LPL is __dependent process

A

insulin

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8
Q

LPL is required for __

A

clearance of lipids from blood

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9
Q

what are our 5 classes of lipoproteins

A
  1. Chylomicrons
  2. VLDL
  3. IDL
  4. LDL
  5. HDL
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10
Q

what 2 lipoproteins are triglyceride rich and therefore cause lipemic serum

A

chylomicrons and VLDLs

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11
Q

hyperlipidemis is increased concentration of __and/or __ in blood

A

cholesterol And/or triglycerides

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12
Q

Lipemia is due to increased concentrations of __ or __

A

VLDL or chylomicrons

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13
Q

how does lipemia affect MCHC and MCH

A

falsely increase

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14
Q

how does lipemia affect TP on refractometer

A

False increase

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15
Q

how does lipemia affect glucose, calcium, phosphorus and tbili

A

false increase

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16
Q

how does lipemia affect TP and albumin on spectrophotometric determination

A

false decrease

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17
Q

how does lipemia affect Na+, Cl- and K+

A

false decrease

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18
Q

what is a common cause of hyperlipidemia in small animals

A

post-prandial (fasted sample prevents this)

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19
Q

what are the pathological causes of hyperlipdemia

A
  1. Primary: congenital defect in lipoprotein metabolism
  2. Secondary to underlying disease
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20
Q

define primary hyperlipidemia

A

congenital defect in lipoprotein metabolism

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21
Q

what dog breed has idiopathic hyperlipidemia and therefore __ and __ are increase

A

miniature schnauzers
Increase triglycerides and cholesterol

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22
Q

what endocrine diseases are associated with secondary hyperlipidemia

A
  1. Hypothyroidism (most common)
  2. DM
  3. Cushings or exogenous corticosteroids
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23
Q

how does hypothyroidism cause secondary hyperlipidemia

A

decrease LPL activity

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24
Q

how does DM cause hyperlipidemia

A

decreased insulin—> defect LPL activity

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25
how does Cushings or exogenous corticosteroids cause hyperlipidemia
excessive glucocorticoids—> increase mobilization of FA from adipose tissue and stimulation of VLDL synthesis and insulin antagonism
26
What is cause of equine hyperlipdemia
negative energy balance or period of stress
27
what are some associated conditions for equine hyperlipdemia
obesity, pregnancy, lactation, renal failure, endotoxemia, insulin resistance
28
equine hyperlipdemia is usually associated with marked __
hypertriglyceridemia
29
30
how does cholestasis cause hyperlipdemia
reduced biliary excretion of cholesterol from hepatocyte Hypercholesterolemia
31
What are the 4 components of nephrotic syndrome
1. Hypoalbuminemia 2. Proteinuria 3. Hypercholesterolemia 4. Edema and/or ascites
32
how does endotoxemia or inflammation cause hyperlipidemia
inflammatory cytokines cause changes in lipid metabolism
33
what are 3 broad causes of hypolipidemia
1. Decreased production 2. Malabsorption/digestion 3. Addisons
34
what are some causes of decreased production of lipids
1. PSS in dogs and cats 2. Hepatic insufficiency or failure
35
what are some causes of malabsorption/digestion leading to hyperlipidemia
1. PLE 2. EPI
36
endocrine or exocrine pancreas: major role in regulation of BG
endocrine
37
endocrine or exocrine pancreases: primary function is synthesis and secretion of digestive enzymes
exocrine
38
what are the 2 major diseases that occur in exocrine pancreas
1. Pancreatitis 2. EPI
39
EPI results in __due to reduced production of pancreatic enzymes
maldigestion
40
what are some clinical signs of pancreatitis
vomiting, diarrhea, fever, inappetence, weight loss, abdominal pain
41
definitive dx of pancreatitis requires __
histologic evaluation of pancreatic tissue
42
what are some lab findings consistent with pancreatitis
1.increase amylase 2. Increase lipase
43
increase amylase and lipase is not reliable indicator of pancreatic injury in what species
cats, cattle and horses
44
What is function of amylase
hydrolyzes carbs
45
what are some causes of increase amylase
1. Pancreatitis 2. Renal disease or decrease GFR 3. Intestinal disease 4. Hepatic disease
46
what is function of lipase
hydrolyze triglycerides
47
what are some causes of increase lipase
1. Pancreatitis 2. Renal disease of decrease GFR 3. Peritonitis 4. Gastritis/enteritis 5. Hepatic disease 6. Pancreatic or hepatic carcinomas
48
why type of leukon is seen with pancreatitis
inflammatory +/- stress
49
is hyper or hypolipidemia sometimes seen with pancreatitis
hyper
50
what are some additional tests you can do you tx pancreatitis
1. Pancreatic lipase immune reactivity 2. Trypsin like immunoreactivity
51
what is the most sensitive and specific test to dx pancreatitis in dogs and cats
pancreatic lipase immunoreactivity
52
what test is used to dx EPI
trysin like immunoreactivity
53
tor f: increase TLI can be seen with pancreatitis and decreased GFR
true
54
define maldigestion in terms of pancreatic function
food not adequately digested to to inadequate secretion of digestive enzymes by exocrine pancreas (EPI)
55
EPI occurs when >__% of exocrine pancreas is nonfunctional
90%
56
what are some signs of EPI
young dogs, thin, ravenous appetite, grey stools (steatorrhea)
57
what is the most common cause of EPI in dogs
pancreatic acinar atrophy
58
what breeds is pancreatic acinar atrophy inherited in
GSD and rough-coated collies
59
what is the most common cause of EPI in cats
secondary to chronic pancreatitis
60
what happens to trypsinogen concentrations in animals with EPI
severely decrease
61
what are some conditions that can cause intestinal malabsoprtion
1. SIBO 2. Lymphangiectasia 3. Decrease intestinal absorptive SA 4. Death of epithelial cells 5. Inflammatory disease 6. Intestinal neoplasia
62
what test can you run to detect defective intestinal absoprtion
serum cobalamin (vitamin b12) and folate concentrations
63
64
SIBO is overgrowth of bacteria in __ and __ leading to __
duodenum and jejunum leading to malabsorption
65
what breed is predisposed to SIBO
GSD
66
what are some lab findings with SIBO
1. TLI WRI (unless SIBO caused by EPI) 2. Decreased cobalamin 3. Increased folate
67
what happens to cobalamin and folate levels with EPI
decreased cobalamin and increased folate
68
how do you determine if SIBO is caused by EPI or other
look at TLI- if normal primary SIBO, if low, then consider EPI
69
what are some causes of PLE
1.mucosal ulceration 2. Inflammation 3. Bleeding 4. Infiltration 5. Lymphangiectasia
70
What are some lab findings consistent with PLE
1. Panhypoproteinemia (albumin and globulins) 2. Lymphopenia 3. Hypocobalaminemia and decreased folate 4. Fecal alpha1 proteinase inhibitor (dogs)
71
how do alpha1 proteinase inhibitor levels change with PLE
increase (early marker for PLE)

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