Pancreatic Diseases Flashcards Preview

Gastrointestinal (LECTURE NOTES) > Pancreatic Diseases > Flashcards

Flashcards in Pancreatic Diseases Deck (43)
Loading flashcards...

What is the role of the pancreas

Serves vital exocrine digestive functions and acts as the site of production of the endocrine hormones, insulin and glucagon, controlling glucose homeostasis


How is self-digestion prevented

By a carefully balanced suppressor system: disruption of that system by a variety of causes can result in pancreatic inflammation called pancreatitis


What can pancreatitis cause

scarring and destruction of pancreatic tissue with resultant loss of exocrine / endocrine function


What do pancreatic lobules consist of

connective tissue surrounding alveoli or pouches that are filled with secretory cells


What are the names of the islands of connective tissue between the alveoli

The islets of Langerhan


What types of cells are contained within the Islets of Langerhan

A and B cells


What are the role of the A and B cells in the islets of Langerhan

they produce the endocrine secretios of the pancreas involved in flucose homeostasis


What are the 3 parts of the pancreas

Head, body and tail


Where does the pancreatic duct commence

In the tail of the pancreas where the small duct from the pancreatic lobules join


What does the dorsal part of the pancreas form

Part of the head, the body and tail


What does the ventral part of the pancreas form

The rest of the head and uncinate process


Where does the pancreas lie initially in embryology

Intraperitoneally between the two layers of the dorsal mesogastrium


Where does the pancreas lie initially in embryology

Intraperitoneally between the two layers of the dorsal mesogastrium


What is released in response to a meal

Release of of cholecystokinin


Name 4 digestive enzymes produced in the pancreas

Amylase (carbs)
Lipase (fats)
Proteases (proteins)
Nucleases (DNA and RNA)


how does amylase work

It hydrolyses polysaccharides in starch and glycogen to maltose and other small oligosaccharides which can then be celaved to glucose by brush border enzymes in the small intestinal mucosa


Where else in the body is amylase produced

Salivary glands


What is the function of Co-lipase

T prevent bile salts from inhibiting the liplysis of triglycerides


Where is trypsin secreted from and as what

The acinar cells as trypsinogen


What is activated trypsin important in

As the common activator of other pancreatic enzymes such as more trypsinogen, chymotrypsinogen, proelastase, procarbosypeptidases and prophospholipase


How does trypsin act

To hydrolyse peptide bonds within the polypeptide chain of proteins


Pancreatic enzymes require a neutral pH to function. How is this environment promoted?

By the secretion of Sodium bicarbonate by pancreatic duct cells to neutralise the gastric acid which enters the duodenum


What is the main association with in chronic pancreatitis

Alcohol abuse


What are the 3 main features of chornic pancreatitis

Pain - epigastric (radiates to back)
Maldigestion - due to glandular destruction - daily exocrine and endocrine requirements cannot be met
Diabetes - pancreatic endocrine insufficiency results in flucose introlerance as insulin production drop below requirements


Why is the diagnosis of chronic pancreatitis often difficult

amylase and lipase levels are frequently normal


How is endocrine dysfunction tested for

Fasting glucose and glucose tolerance testing if indicated


How is exocrine function tested

using faecal elastase
reduced levels indicating reduced exocrine function


What provides the best means of assessing the degree of calcification of the pancreas

CT scan


What is the management for chronic pancreatitis

Largely symptomatic and aimed at managing pain and exocrine and endocrine insufficiency as well as nutritional support
Avoidance of alcohol and smoking


Aggressive glucose management should be reserved for who

Patients with good compliance and cessation of alcohol