Flashcards in Pancreas & GI System Deck (46)
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1
Pancreas endocrine functions
insulin
glucagon
somatostatin
2
pancreas exocrine functions
enzymes for digestion & bicarb ion to neutralize acids in intestine
amylase (CHO) & lipase (fats)
trypsin, chymotrypsin, elastase, collegenase, leucine aminopeptidase
3
pancreas nerve control
vagus nerve branches
stimulates small amount of secretions responding to food smell /view
4
pancreas endocrine control
CCK & Secretin
5
Secretin
made in response to HCL acid @ duodenum in small intestine
leads to pancreas release of bicarb ion
6
CCK
cholecystokinin from intestinal mucosa
causes pancreas to release digestive enzymes
7
pancreatic diseases
cystic fibrosis
pancreatic cancer
pancreatitis
8
Cystic fibrosis
dysfunction of mucous & exocrine glands throughout the body
see intestinal obstruction, pulmonary infections & pancreatic malabsorption
ch 7 gene CFTR
9
sweat chloride test
>60 mEg/L is diagnostic
done at least twice
10
sweat chloride test
>60 mEg/L is diagnostic
done at least twice
apply pilocarpine to skin, collect sweat, measure
11
Pancreatic Carcinoma
death w/in 1 yr for 90% of diagnosed cases
tumors in tail & body of pancreas missed until advanced
12
signs of pancreatic carcinoma
jaundice (post-hepatic), weight loss, anorexia, nausea
islets of pancreas make excess insulin
overproduction of gastrin in Zollinger-Ellison syndrome
13
Acute Pancreatitis
inflammation of pancreas (usually reversible)
autodigestion of gland due to reflux of bile &/or duodenal contents into pancreatic duct
14
causes of acute pancreatitis
alcohol abuse
mumps
obstruction of biliary tract
gallstones
pancreatic tumors
atherosclerotic disease
shock
pregnancy
hypercalecemia
immunologic factors associated w/ transplantation
15
lab tests for acute pancreatitis
amylase 2-3x
lipase elevated but as much as amylase
increased triglycerides, variable calcium levels
decreased 02
16
Chronic pancreatitis most common cause
alcohol abuse
17
chronic pancreatitis signs/symptoms/things associated w/ it
edema & fluid buildup in peritoneal cavity w/ associated decrease in blood volume
acinar cells of pancreas become infiltrated by inflammation
can develop hemorrhage & necrosis
18
chronic pancreatitis labs
increased lipase, triglycerides, & calcium
decreased 02
19
'give away' for chronic pancreatitis
elevated lipase & normal amylase
hemorrhage is exclusively chronic
20
relapse/recurrent pancreatitis
causes similar to acute pancreatitis
either acute or chronic w/ similar labs
21
symptom/lab result that is common to all pancreatitis
steatorrhea - greasy feces >5g/24hr fecal fat
& malabsorption
22
pancreatic function testing
amylase & lipase
malabsorption using D-xylose
CCK, secretin, fecal fat, trypsin, chymotrypsin
bilirubin & ALP (biliary obstruction)
assays for gastrin, insulin, glucose
secretin clearance test
23
Secretin clearance testing
give IV secretin, follow w/ CCK
collect secretions for 30, 60, or 80 mins in either 10 min intervals or as a single pool
measure pH, secretion rate, enzyme activities, & bicarb ion
24
Fecal Fat analysis
qualitative testing: lipid stains such as Sudan III, Oil red O, nile blue sulfate
quantitative: collect stool for 3 days & use gravimetric, titrimetric, infrared & nuclear magnetic resonance spectroscopy
25
when is steatorrhea seen?
biliary obstruction
pancreatic insufficiency
disease of small intestine
26
gravimetric method
extract fatty acids into organic solvent
aliquot in pre-weighed container
evaporate solvent
weigh residue
take difference in weight
1-7 g/24 hr range
27
Titrimetric method
extract saponified lipids, evaporate solven, reconstitute in ethanol, titrate w/ NaOH
results are 20% less than gravimetric method
28
cases w/ amylase increases
75% of acute pancreatitis
burns
sepsis
diabetic ketoacidosis
29
parietal cells
produce HCl acid & intrinsic factor (facilitates absorption of vit B12 in ileum)
30
