Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Ettinger Notes > Pancreatic > Flashcards

Pancreatic Flashcards

1
Q

list risk factors for pancreatitis

A

hypertriglyceridemia, obesity, infections? breed, genes? drug reactions, intoxications, endocrine disease, trauma/surgery, hypercalcemia?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

in dogs with serum triglyceride levels >= xx mg/dL (xx mmol/L), a xx-fold higher likelihood of having serum cPLI values consistent with pancreatitis have been seen

A

> = 862mg/dL (9.7 mmol/L), 4.5-fold

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what drugs have been associated with acute pancreatitis?

A

potentiated sulfonamides, azathioprine, L-asparaginase, meglumine antimonate, N-methyl-glucamine, clomipramine, phenobarbital/KBr; CCK-8 and cerulein can be used to induce AP in dogs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what intoxications have been reported as causes of AP?

A

zinc, vipera xanthina palestinae envenomation, organophosphate (dog only)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what endocrine disorders have been linked to canine AP?

A

hyperadrenocorticism, hypothyroidism, diabetes mellitus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

previous surgery other than neutering has been associated with an increased odds ratio (OR = xx) for pancreatitis in dogs

A

OR = 21.1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

the key factor initiating pancreatic inflammation is what?

A

activation of trypsin within the acinar cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

why would trypsin be activated within acinar cells? (3 reasons)

A

blockage of acinar cella pex in pancreatic duct leading to co-localization and fusion of zymogen and lysosomal granules; oxidative stress; hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is the self-defense mechanism against activated trypsin?

A

neutralization by pancreatic secretory trypsin inhibitor, which is overwhelmed when more than 10% of intracellular trypsin is activated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what causes the switch from inflammation to necrosis in AP?

A

neutrophils, endothelin-1, phospholipase A3. disturbed pancreatic microcirculation and increased vascular permeability -> edema and necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what inflammatory mediators are involved with AP progressing to ANP?

A

TNFa, IL1b, IL6, IL10, PAF, ICAM-1, CD40L, complement component C5a, chemokine, substance P, hydrogen sulfide, kinin-kallikrein and RAAS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

discuss NK-1 in AP

A

pancreatic substance P and NK-1 receptors are highly unregulated in mice with AP, and knockout mice deficient in NK1 receptors are protected against AP and associated lung injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

why isn’t serum amylase recommended for diagnosis of pancreatitis?

A

some dogs with pancreatitis do not show increase in amylase, and amylase increases can be seen with many conditions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

1 treatment for pancreatitis?

A

aggressive fluid therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what % of dogs with severe pancreatitis are found to be painful in the abdomen?

A

58%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

FFP and fresh whole blood contain what elements that may be beneficial to dogs with AP?

A

alpha2-macroglobulin, albumin, anticoagulant and coagulation factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what drug has been shown to be useful in preventing progression of pancreatitis in cats with experimentally induced pancreatitis when administered within 12 hours of initiating the disease?

A

dopamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is the most common disorder of the exocrine pancreas in cats?

A

pancreatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

most common c/s in cats with pancreatitis?

A

inappetence > lethargy > dehydration > vomiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

the presence of hypocalcemia in a pancreatitis case is associated with what?

A

presence of severe, necrotizing pancreatitis

21
Q

XX has the highest currently reported sensitivity (xx%) and specificity (xx%) of any diagnostic modality for the detection of pancreatitis in the cat

A

spec fPL; 79% sensitivity, 82% specificity

22
Q

what type of diet is recommended for canine & feline pancreatitis patients?

A

dog: ultra-low fat. cat: novel protein or hypoallergenic

23
Q

why isn’t a low fat diet recommended for cats with pancreatitis?

A

they have a high constitutive requirement for arachidonic acid

24
Q

what is the most common cause of EPI?

A

absolute lack of pancreatic acinar cells that is due to destruction of acinar cells due to chronic pancreatitis (dogs and cats) or depletion of acinar cells due to pancreatic acinar atrophy (dogs)

25
Q

roughly what % of dogs with EPI are due to chronic pancreatitis versus pancreatic acinar atrophy?

A

50/50

26
Q

what % of cats with EPI are due to chronic pancreatitis versus pancreatic acinar atrophy?

A

100/0

27
Q

clinical signs of EPI ensure when more than xx% of exocrine pancreatic function has been lost

A

90%

28
Q

explain the theory behind why EPI leads to malabsorption

A

due to a lack of trophic factors normally secreted by the exocrine pancreas that help maintain normal GI mucosa

29
Q

what % of cats and dogs with EPI have hypocobalaminemia?

A

82% of dogs have hypocobalaminemia (36% marked hypocobal); 100% of cats

30
Q

why do so many animals with EPI have low cobalamin?

A

intrinsic factor is mainly secreted from the exocrine pancreas

31
Q

most common c/s in dogs and cats with EPI?

A

weight loss

32
Q

describe the clinical presentation of an animal with EPI

A

weight loss, loose stools; watery diarrhea uncommon. poor hair coat, borborygmus, flatulence. increased appetite, coprophagia, pica. cats may have greasy soiling of hair coat in perineal region.

33
Q

diagnostic test of choice for EPI?

A

TLI

34
Q

TLI measures what?

A

concentration of cationic trypsinogen, cationic trypsin, and some cationic trypsin molecules bound to proteinase inhibitor molecules

35
Q

list 2 scenarios in which TLI could be normal in a patient with EPI

A

isolated pancreatic lipase deficiency. patient with obstructed pancreatic duct.

36
Q

what is a concern with a patient diagnosed with EPI based on fecal elastase?

A

high number of false positives (23%): confirm diagnosis with TLI

37
Q

if you have a patient on pancreatic enzyme powder that develops oral bleeding, what should your first step be?

A

check a coagulation panel: vitamin K responsive coagulopathies have been reported in two cats with EPI

38
Q

what diseases can potentially be transmitted using raw pancreas to treat EPI?

A

bovine and ovine pancreas: bovine spongiform encephalopathy. pork: pseudorabies (aujeszky’s dz) [dried pancreatic powder can also transmit these]. game and ovine: echinococcus

39
Q

what type of diet should be avoided in dogs with EPI? why?

A

high fiber: dietary fiber may interfere with fat absorption

40
Q

if a dog or cat is diagnosed with EPI, what else should you test for?

A

cobalamin levels

41
Q

serum concentrations of what types of vitamins are decreased in dogs with EPI?

A

fat-soluble

42
Q

list the prognostic factors for EPI

A

hypocobalaminemia

43
Q

what things should you consider if your EPI patient isn’t responding to enzymes and cobalamin?

A

concurrent disease (IBD, DM, dysbiosis), enzyme replacement dose, consider tylosin trial, consider omeprazole trial (to decrease amount of lipase supplement is destroyed by gastric pH)

44
Q

what breed & gender are predisposed to exocrine pancreatic tumors?

A

females, airedale terriers

45
Q

what mutation has been identified in people and dogs with exocrine pancreatic cancer?

A

K-ras

46
Q

what are the most common metastatic sites for exocrine pancreatic cancers?

A

duodenum, regional LNN, liver, lungs, carcinomatosis

47
Q

what paraneoplastic syndrome has been seen in cats with exocrine pancreatic neoplasm?

A

alopecia, most prominent on ventral abdomen +/- limbs and paws. Other reported metastases/paraneoplastic things: bone mets, multifocal necrotizing steatitis, PU/PD d/t hypercalcemia

48
Q

how does exocrine pancreatic neoplasia lead to icterus?

A

compression of extra hepatic bile duct; 10% of cases of EHBDO are d/t pancreatic exocrine carcinoma

49
Q

discuss prognosis of exocrine pancreatic carcinoma

A

poor. cats - overal MST 97d; if sx or chemo - 165d. palliative tx or abdominal effusions- 26 and 38d, respectively

Ettinger Notes (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions