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Clinical Pathology Exam 4 > Lecture 2 > Flashcards

Lecture 2 Flashcards

(59 cards)

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1
Q

What cells are in the exocrine pancreas? What do they release?

A

Acinar cells- digestive enzymes

Ductular cells- electrolytes, intrinsic factor, antibacterial proteins

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2
Q

What does the exocrine pancreas do?p

A

Source of digestive enzymes, bicarb rich secretions to neutralize gastric secretions, source of intrinsic factor for cobalamin absorption, secretes antibacterial proteins

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3
Q

What are two common exocrine pancreas disorders?

A

Pancreatitis, exocrine pancreatic insufficiency

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4
Q

What prevents autodigestion?

A

The enzymes are made as zymogens that have to be activated in the duodenum by trypsin

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5
Q

What is triaditis

A

Inflammation of liver, pancreas, and small intestine in cats

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6
Q

What possible CBC abnormalities will you see with pancreatitis?

A

Neutrophilia with left shift and toxicity
Lymphopenia
Thrombocytopenia

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7
Q

What possible chem abnormalities will you see with pancreatitis?

A

High cholesterol, ALT, ALP, bilirubin, and glucose

Low calcium

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8
Q

What pancreatic enzymes can we measure?

A

Trypsins
Alpha amylase
Lipase

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9
Q

What is amylase produced by?

What is it cleared by?

A

Produced by pancreatic acinar cells, small intestine, and saliva in pigs

Cleared by kidney

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10
Q

What could increased amylase mean?

A

Pancreatic disease, GI disease, Renal failure, other causes of decreased GFR (pre or post renal)

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11
Q

What does decreased amylase mean?

A

Nothing

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12
Q

What is lipase produced by?

What is it cleared by?

A

Pancreatic acinar cells, gastric mucosal cells, small intestine, liver, adipocytes, myocytes

Cleared by kidney

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13
Q

If lipase is increased more than 3 fold, what is it likely due to?

A

Pancreatic disease

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14
Q

When would lipase be decreased?

A

EPI

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15
Q

What is PLI?

A

Measure of specific pancreatic lipase

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16
Q

What is EPI?

A

Exocrine pancreatic insufficiency- insufficient synthesis and secretion of digestive enzymes

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17
Q

What can cause EPI (maldigestion)

A 
Congenital abnormality
Chronic pancreatitis
Pancreatic duct obstruction
Ischemia
Immune mediated disease
Toxic damage
Infection
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18
Q

What can be associated problems with EPI?

A

Concurrent diabetes mellitus
Secondary small intestine bacterial overgrowth
Secondary cobalamin deficiency

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19
Q

What will you see on CBC/chem with EPI?

A

Mostly normal

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20
Q

When will trypsin increase?

Decrease?

A

Pancreatitis, pancreatic hypertrophy, renal disease, small intestinal disease

EPI

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21
Q

What test is best for diagnosing EPI?

A

Trypsin

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22
Q

What can cause GI disease (malabsoprtion)?

A

Inflammation/cancer thickening the GI tract

Parasitism or other infection

Lymphatic disease

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23
Q

What are major causes of chronic intestinal disease in small animals?

A 
IBD
Triaditis in cats
GI lymphoma
Lymphangiectasia (dogs only)
Pythiosis (dogs only)
GI histoplasmosis
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24
Q

What are malabsorptive diseases in equids?

Study These Flashcards
A

Lymphoma
IBD
Infectious

25
What are malabsorptive diseases in bovine?
``` Calf diarrhea Johnes disease (mycobacterium) ```
26
What are causes of hypocholesterolemia?
Decreased hepatic synthesis (liver disease, PSS) Decreased intestinal absorption (PLE) Maldigestion (EPI) Hypoadrenocorticism
27
What does insulin do to glucose?
Causes glucose to go into cells and decrease serum glucose
28
What does glucagon, catecholamines, growth hormone, and corticosteroids do to glucose?
Antagonize insulin and cause glucose to not be taken up into cells and increase serum glucose
29
What might cause a artifactual decreased glucose?
Not separating the serum from cells within 30 minutes (because the cells will continue using glucose)
30
What are some clinical signs of hypoglycemia?
``` Lethargy Incoordination Exercise intolerance Seizures Coma ```
31
What would cause hypoglycemia (increased insulin secretion)
Insulinoma | Xylitol toxicity
32
What would cause hypoglycemia | Decreased insulin antagonists
Hypocortisolemia
33
What would cause hypoglycemia | Decreased gluconeogenesis
Liver insufficiency/failure Hypocortisolemia Neonatal hypoglycemia Starvation/ severe malnutrition
34
What would cause hypoglycemia | Increased glucose utilization
Lactation | Exertion
35
What would cause hypoglycemia | Uncertain pathogenesis
Sepsis | Neoplasms
36
What would cause hypoglycemia | Pharmacologic
Insulin | Sulfonylurea compounds
37
What would cause hyperglycemia?
``` Post prandial Catecholamine induced (fractious animal) Steroid induced Diabetes, Cushings, acromegaly, hyperpituitarism (PPID) Dextrose, xylazine, ketamine Glucogonoma Pancreatitis Early sepsis Proximal duodenal obstruction in cattle Sick neonatal llamas and alpacas ```
38
When would a fecal test for malabsorption be helpful?
When PLE is suspected
39
What is SIBO?
ARE | Overgrowth of bacteria in intestine
40
What causes SIBO?
EPI Other intestinal disorders Idiopathic
41
When would folate/B9 be increased? | What produces it?
ARE/ SIBO Bacteria
42
When would cobalamin (B12) be decreased?
ARE/SIBO
43
Describe serum values fro EPI
Folate- normal or increased Cobalamin- decreased TLI- decreased
44
Describe serum values for SIBO
Folate- increased Cobalamin- decreased TLI- normal
45
Describe serum values for proximal small intestinal disease
Folate- decreased Cobalamin- normal TLI- normal
46
Describe serum values for distal small intestinal disease
Folate- normal Cobalamin- decreased TLI- normal
47
Describe serum values for diffuse small intestinal disease
Folate- decreased Cobalamin- decreased TLI- normal
48
When might BUN:creat be high (GI)
Pre renal azotemia or GI hemorrhage
49
When would TP be low (GI)
PLE
50
When would albumin be low (GI)
PLE
51
When would globulins be low (GI)
PLE
52
When would cholesterol be low (GI)
PLE
53
When would calcium be low (GI)
Intestinal malabsorption or secondary to hypoalbuminemia
54
When would magnesium be low (GI)
Low with decreased intake (anorexia), decreased GI absorption
55
When would phosphorus be low (GI)
Decreased intake (anorexia) or decreased GI absorption
56
When would sodium be low (GI) | When would sodium be high (GI)
High if pure water is lost through GI tract | Low if isotonic or sodium rich fluid is lost through GI tract
57
When would potassium be low (GI)
If lost in GI tract +/- anorexia
58
When would chloride be high (GI) | Low? (GI)
High if pure water is lost by GI tract Low if isotonic fluid or chloride rich fluid is lost through GI Disproportionally elevated relative to sodium if bicarb is being lost
59
When would bicarb be high (GI) | Low?
High with upper GI disease and selective loss of HCl | Low if losing bicarb in diarrhea

Clinical Pathology Exam 4 (4 decks)

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