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UNIT 5 GI > P4 BIOCHEMISTRY > Flashcards

P4 BIOCHEMISTRY Flashcards

1
Q

Direct evaluation of pancreatic fluid measures

A

Fluid volume
Concentration of enzymes & HCO3

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2
Q

Your investigations for malabsorption

A

Microscopic stool examination for fat , starch , meat fiber, D-xylose

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3
Q

Your investigations for acute pancreatitis

A

Measurement of lipase & amylase

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4
Q

Your investigations for endocrine function

A

Measure insulin , glucagon , blood glucose

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5
Q

Your investigations for exocrine function

A

Measure trypsin , chymotrypsin

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6
Q

types of exocrine pancreatic function test

A

Direct , indirect

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7
Q

Indirect test is done on

A

stool , urine , breath test

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8
Q

stool test is to detect

A

fat , nitrogen
stool trypsin & chymotrypsin
elastase-1

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9
Q

Sensitivity of Elastase -1

A

100%

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10
Q

Specificity of elastase -1

A

96%

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11
Q

test of urine is done to detect

A

bentiromide
pancreolauryl-fluoresceine
trypsinogen-2

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12
Q

bentiromide is attached to

A

PABA

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13
Q

lower levels of elastase-1 indicates

A

Pancreatic insufficiency

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14
Q

Advantages of elastase-1 test

A

not affected by pancreatic enzymes replacement
only 1 stool sample

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15
Q

triolein is labelled with

A

C14

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16
Q

triolein test is done to investigate

A

Absorption of fat

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17
Q

low levels of CO2 in triolein breath test indicates

A

Inadequate pancreatic lipase

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18
Q

bentiromide is a

A

peptide

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19
Q

bentiromide gets broken down into

A

4-aminobenzoic acid

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20
Q

4 aminobenzoic acid will be excreted in

A

urine

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21
Q

Process of breaking bentiromide to aminobenzoic acid is done by

A

chymotrypsin

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22
Q

this test is no longer used in US , Canada due to

A

side effects : diarrhea , headache , gas , nausea , vomiting , weakness

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23
Q

name the test in which you detect cholesterol ester hydrolase in pancreatic juice

A

pancreolauryl-fluorescein dilaurate test

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24
Q

florescein is excreted in

A

urine

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25
Q

if the ratio is less than 20% is considered

A

abnormal , less amount of cholesterol ester hydrolase

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26
Q

Glycoprotein that binds strongly with vitamin B12

A

R factor / haptocorin

27
Q

R factor / haptocorin is produced by what glands

A

Salivary glands

28
Q

R factor binding to B12 helps in

A

Protecting B12 from acidic environment of stomach

29
Q

schilling test is done to

A

Determine how well the patient absorbs B12 from their intestinal tract

30
Q

Cystic fibrosis can be diagnosed by measuring

A

sweat sodium and chloride

31
Q

Mechanism of collecting sweat

A

Electrodes on forearm , administering pilocarpine

32
Q

Patients with CF sodium and chloride concentration will be

A

2-5 folds increase

33
Q

Maximum increase in regular adults chloride and sodium levels

A

80mmol/L

34
Q

Disadvantage of sweat test

A

it doesn’t distinguish between CF carriers from affected patients

35
Q

sources of fat in feces

A

Dietary
Excreted from bile
shedded cells
Intestinal bacteria

36
Q

types of fat present in feces

A

free fatty acids
sterol
triacylglycerides

37
Q

Maximum amount of fat excreted in feces

A

7 g/day

38
Q

incase of steatorrhea it can indicate

A

exocrine pancreatic insufficiency
small intestine disease
biliary obstruction

39
Q

fat soluble stains

A

sudan 3 or 4
oil red O or nile blue sulfate

40
Q

upon adding sudan 3 to TAG it will stain

A

Yellow to red

41
Q

before staining free fatty acids you need to

A

heat it in the presence of 36% acetic acid

42
Q

Requirements for detection of undigested meat fibers

A

10% alcohol , eosin stain

43
Q

increased fats % meat fibers in stools indicates

A

Pancreatic steatorrhea

44
Q

mention the 2 techniques for fecal fat analysis

A

1- gravimetric method
2- titration method

45
Q

steps of gravimetric method of sobel

A

Emulsification of stool with water
Acidification
extraction of lipids

46
Q

extraction of lipids is done with

A

ether * ethanol

47
Q

results of fecal fat analysis is expressed as

A

g of fecal fat / 24 h

48
Q

in titration method fatty acids are titrated with

A

Standardised KOH

49
Q

why is the results of titration always 20% lower than gravimetric method

A

is only measures saponifiable fatty acids

50
Q

Direct / invasive test

A

Sec/CCK test

51
Q

in Sec/CCK test , the patient will get an IV of

A

secretin followed by CCK

52
Q

Secretin /CCK test is done to determine

A

Volume , flow rate , pH , bicarbonate , enzymes activity

53
Q

low flow & increased enzymes indicates

A

Pancreatic obstruction

54
Q

Decreased HCO3 & enzymes indicates

A

cystic fibrosis , chronic pancreatitis

55
Q

enzyme that is useful in diagnosis of acute pancreatitis

A

serum amylase

56
Q

normal values of serum amylase

A

less than 3.1%

57
Q

Average values in acute pancreatitis

A

8 - 10 %

58
Q

Increased serum amylase with normal urine amylase indicates

A

macroamylasemia

59
Q

macroamylasemia is due to

A

binding of amylase to globulins thus not excreted in urine

60
Q

Enzyme that is useful for detection of pancreatic necrosis / pancreatitis

A

lipase

61
Q

both lipase & amylase might be increased in

A

Pancreatic cancer / trauma
Intestinal obstruction / perforation

62
Q

Amylase level increases in

A

Cirrhosis , cholecystitis , mumps , hepatitis

63
Q

lipase levels increases in

A

bone fractures , fat embolism

UNIT 5 GI (34 decks)

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