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tv4001 > Pancreatitis and maldigestion/malabsorption > Flashcards

Pancreatitis and maldigestion/malabsorption Flashcards

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1
Q

how much of the mass does the exocrine pancreas make up

A

90%

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2
Q

what is the role of the exocrine pancreas

A

synthesis of digestive enzymes into the duodenum that break down proteins, carbs and fat
also secrete bicarbonate

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3
Q

what causes pancreatitis

A

premature activation of digestive enzymes within the pancreas

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4
Q

systemic signs of pancreatitis caused by the release of inflammatory cytokines

A 
generalized inflammation
liver disease 
DIC 
hypotension 
renal failure or pulmonary failure
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5
Q

what prevents pancreatic autodigestion

A

pancreatic enzymes sequestered in acinar cells are in inactive form. they only become activated after reaching the duodenum
acinar cells also make pancreatic secretory trypsin inhibitors which inactivates any trypsin that is prematurely activated with granules

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6
Q

is it normal for small amounts of pancreatic enzymes to leak from pancreas into circulation?

A

yes, usually circulating protease inhibitors neutralize activated enzymes

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7
Q

causes for pancreatitis

A
  • dietary fat
  • non diet related hyperlipidemia (DM, cushings, hypothyrpodism etc)
  • drugs
  • pancreatic ischaemia
  • pancreatic duct obstruction
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8
Q

clinical signs of pancreatitis

A 
vomiting 
weakness 
abdominal pain 
dehydration 
diarrhea 
fever
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9
Q

CBC findings for pancreatitis

A

non specific
thrombocytopenia
neutrophilia and left shift
anemia

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10
Q

what is the best test for canine pancreatitis

A

cPLI

binds specifically to pancreatic lipase

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11
Q

what is the reference range of cPLI for pancreatitis

A

0-200 normal
>400 consistent with pancreatitis
retest in 2-3 weeks if between 200 and 400

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12
Q

pancreatitis complications

A 
DIC 
systemic inflammatory disease 
organ dysfunction 
recurrence or death 
pancreatic abscessation
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13
Q

treatment

A 
nutrition 
fluid therapy 
pain control 
correction of electrolyte abnormalities 
antiemetics
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14
Q

pancreatits in cats

A

most common disorder of exocrine pancreas in cats

cats usually have chronic pancreatitis where as dogs have acute

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15
Q

clinical signs of pancreatits in cats

A

lethargy
anorexia
dehydration

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16
Q

diagnosis of pancreatitis in cats

A

histopathology
specific fPLI
ultrasound

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17
Q

interpretation of fPLI

A

<3.5 normal range
3.6-5.3 = may have pancreatitis, retest in 2 weeks
>5.4 = pancreatitis

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18
Q

what does mild erythrocytosis indicate

A

dehydration

increased RBC, Hgb and Hct

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19
Q

what does moderate leukocytosis, moderate neutrophilia, with left shift, monocytosis and lymphopenia indicate

A

inflammation and stress

leukopenia = stress

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20
Q

what does low chloride indicate

A

vomiting

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21
Q

what indicates azotemia

A

BUN and creatine increase

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22
Q

what does increased amylase and lipase suggest

A

pancreatitis

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23
Q

what does increased cholesterol, total bilirubin and ALP indicate

24
Q

what does increased ALT indicate

Study These Flashcards
A

hepatocellular damage

25
what is hyperglycaemia likely due to
stress
26
post mucosal malabsorption
lymphatic obstruction
27
maldigestion
failure to adequately digest food | usually due to inadequate secretion of pancreatic digestive enzymes
28
protein losing enteropathy clinical signs
vomiting, diarrhea, weight loss oedema and ascites thromboembolism albumin and globulin lose at same degree
29
what is EPI
inadequate pancreatic secretions causing incomplete digestion of food which subsequently causes inadequate absorption of nutrients
30
causes of EPI
pancreatice acinar atrophy (PAA) chronic pancreatitis pancreatinc hypoplasia pancreatic neoplasia
31
pancreatic acinar atrophy (PAA)
immune mediated, begins with lymphocytic pancreatitis and gradually leads to destruction of pancreatic acinar tissue
32
clinical signs of EPI
``` diarrhoea weight loss increased faecal volume raveouns appetite steatorrhea poor hair coat ```
33
test of choice for EPI
TLI (trypsin like immunoreactivity) detects both trypsinogen and trypsin index of pancreatic function
34
TLI interpretation dogs
<2.5 are diagnostic for EPI
35
TLI interpretation cats
< 8 are diagnostic for EPI
36
additional tests to run for EPI
folate and cobalamin (B12)
37
how does EPI cause cobalamin deficiency
failure to secrete HCO3 rich fluid and protease into duodenum results in decreased production of intrinsic factor from the pancreas which then leads to intestinal bacterial overgrowth. The bacteria bind to cobalamin which decreases the amount available for absorption
38
how does EPI affect folate levels?
folate can be normal to increased in EPI. enteric bacteria can produce folate. lower intestinal pH enhances folate absorption through the jejunum
39
SIBO (small intestinal bacterial overgrowth)
substantial numbers of bacteria in the upper small intestine and the host responds to them in such a manner as to cause intestinal dysfunction
40
diagnosis of SIBO
hard to definitively diagnose - low serum cobalamin - increased serum folate
41
malabsorption
failure of intestinal tract to absorb adequately digested nutrients
42
mechanisms of malabsorption
premucosal | mucosal
43
premucosal malabsoprtion
rapid intestinal transit - hyperhtyoidism lack of pancreatic enzymes - EPI SIBO
44
mucosal malabsorption
inflammation infection parasites neoplasia
45
explain IBD
inflammation leads to alterations in intestinal contents and disruptions of normal microflora, potentially causing bacterial overgrowth, which affects the intestines ability to absorb nutrients
46
post mucosal malabsorption
lympahtic obstruction
47
what are malabsorptive disorders of the small intestine commonly associated with?
concurrent protein losing enteropathy
48
protein losing enteropathy clinical signs
vomiting, diarrhea, weight loss oedema and ascites thromboembolism albumin and globulin lose at same degree
49
what are the three lipids in the body
triglyceride cholesterol phospholipids
50
what do triglycerides do
provide energy source and primary lipid in adipose tissue
51
what do cholesterol and phospholipids form
cell membranes
52
hyperlipidemia
increase in levels of any or all lipids in plasma
53
what hyperlipdemia cause is most common
post prandial | pathological hyperlipidemia is usually secondary to underlying disease
54
when is hyperlipidemia most likely seen
in patients with hypothyroidism or diabetes mellitus
55
when is hypertriglyceridemia usually seen
in diabetes mellitus hyperadrenocorticism excessive negative energy balance

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