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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

Chief cells

pepsin cells
make pepsinogen - converted by acid to pepsin to break down proteins