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Alimentary > 1 - Pancreas > Flashcards

1 - Pancreas Flashcards

1
Q

Does the dog or the cat have fused bile duct

A

Cat

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2
Q

Acinar cells synthesize

A

Inactive enzymes and store them in zymogen granules

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3
Q

Acute pancreatitis

A

Inflammatory disease characterized by inflammatory cell infiltration of the exocrine pancreas, edema, and necrosis

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4
Q

What are some possible risk factors in dogs with AP

A
  • hypovolemia
  • nutrition
    -hyperlipoproteinemia
    -endocrine conditions
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5
Q

How does pancreatitis cause hypovolemia

A

Plasma loss into peri pancreatic tissues and peritoneal cavity, pooling of fluid in lumen of gut due to ileus, dehydration from vomiting, diarrhea and lack of intake

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6
Q

How does pancreatitis cause peritonitis

A

Leakage of pancreatic enzymes into peritoneal cavity cause local inflammation and increase vascular permeability

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7
Q

What cells synthesize zygomens

A

Acinar cells

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8
Q

Zygomen granules are segregated

A

In the lumen of the rough ER

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9
Q

When are the zygomen granules activated

A

Duodenum - small intestines

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10
Q

Plasma a - macroglobulins bind proteases to enable

A

Macrophage uptake

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11
Q

What secretes juice into the duodenum

A

Exocrine pancreas

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12
Q

The initial food response is

A

Initial phase rich in enzymes

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13
Q

The second food response is

A

Rich in bicarbonate

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14
Q

Food related secretion is due to what two things

A

Cephalic stimulation and gastric and intestinal stimulation

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15
Q

What pancreatic enzymes are present at low concentration in teh plasma of normal animals

A

Amylase, lipase, and trypsin

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16
Q

Acute pancreatitis is recognized more often in

A

Dogs

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17
Q

Acute pancreatitis

A

An inflammatory disease characterized by inflammatory cell infiltration of the exocrin pancreas, edema, and necrosis associated with acute onset of a wide range of clinical signs

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18
Q

Most commonly pancreatitis is caused by the auto digestion of the pancreas due to premature activation of digestive zyogmens where

A

Within the acinar cells

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19
Q

Alpha cells secrete

A

Glucagon

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20
Q

B cells secrete

A

Insulin

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21
Q

D cells secrete

A

Somastatin

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22
Q

What activates trypsinogen into trypsin

A

Enterokinase

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23
Q

Trypsin becomes activated in what type of pH

A

Low

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24
Q

What does the body do to keep the pH high to prevent activation of trypsin

A

NaHCO3

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25
Q

What does zygomen granules do if there is an apical block

A

Leak into the interstitial space causing inflammation of surrounding fat

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26
Q

Risk factors of pancreatitis in dogs

A

Ischemia, nutrition, hyperlipoproteinemia ( fat), endocrine conditions

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27
Q

What mediates protection against leakage of enzymes into the blood

A

Alpha macroglobulin, alpha protease inhibitors

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28
Q

Pancreatic inflammation and edema can lead to

A

Ischemia, infarction, hemorrhage, and necrosis

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29
Q

Inflammatory cytokines enter systemic circulation and cause

A

Systemic signs

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30
Q

What is the gold standard for DX pancreatitis

A

Histopathology

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31
Q

What is seen on Histopathology in acute pancreatitis

A

Neutrophilic inflammation , oedema, and necrosis

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32
Q

What is seen in chronic pancreatitis on histo

A

Fibrosis and acinar loss

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33
Q

Clinical signs of dogs with acute pancreatitis

A

Vomiting and abdominal pain

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34
Q

General pancreatitis clinical signs

A

Anorexia, vomiting, depression, prayer position, fever, shock, DIC

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35
Q

What can be found on Clin path for pancreatitis

A

Left shift , hyper lipid, azotemia, low calcium

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36
Q

Pancreatitis spec test is

A

Quantative

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37
Q

Pancreatitis snap test is

A

Qualitative

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38
Q

If there is a negative Lipase DGGR

A

Exclude pancreatitis

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39
Q

What could increase cPLI and DGGR

A

Renal, cardiac, diabetes, hyperadrenocorticim, GIT inflammation

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40
Q

Can spec CPLI rule out pancreatitis if negative

A

Yes

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41
Q

2 pancreatic test for feline

A

FPLI and lipase DGGR

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42
Q

What are some findings on radiographs with pancreatitis

A

Left displaced pylorus, R displaces duodenum, enlarged pancreas, duodenal lines, peritonitis

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43
Q

Is a CT good for pancreatitis

A

Poor choice in small animals

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44
Q

On ultrasounds, the pancreas is normally

A

Isoechoic to the fat

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45
Q

What does a pancreas on ultrasound look like with pancreatitis

A

Enlarger hypoechic pancreas with hyperechoic fat

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46
Q

What are the only times to do cytology in pancreatitis case

A

Neoplasia or abscess

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47
Q

What are the possible consequences of pancreatitis

A

Hypovolemia, peritonitis, hepatobiliary complications, pulmonary and or pleural disease, DIC, cardio, fat necrosis

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48
Q

Pancreatitis can cause hypovolemia due to

A

Plasma loss into peri pancreatic tissues and peritoneal cavity, pooling of fluid in lumen of gut due to ileus, dehydration from vomiting, diarrrhea or lack of intake

49
Q

With hypovolemia you should monitor

A

BP, hydration, and calculate fluid needs

50
Q

Peritonitis may be localized where

A

Right upper quadrant

51
Q

Peritonitis

A

Leakage of pancreatic enzymes into peritoneal cavity which can cause inflammation and increased vascular permeability

52
Q

What to monitor with peritonitis

A

Albumin, total solids, assess potion for edema or 3rd spacing of fluids

53
Q

Peritonitis may cause

A

Hepatobiliary complications such as choleostasis

54
Q

Describe hepatobiliary complications

A

Obstruction of bile duct due to edema or fibrosis leads to extrahepatic biliary obstruction or due to dysfunction of biliary duct lead to miminal gall bladder contraction and bile excretion

55
Q

Why can you get pulmonary disease with pancreatitis

A

Damage to pulmonary capillary and alveoli and lad to edema, ARDS, or SIR

56
Q

List reasons for pulmonary disease

A

Aspiration pneumonia from vomiting, pulmonary thromboembolism, pleural effusion due to vascular leakage of fluid

57
Q

Cardiac arrhythmias may develop with pancreatitis due to

A

Myocarditis

58
Q

Saponification

A

Free fatty acids and calcium combine to form insoluble soaps - white nodules in pancreas

59
Q

Pancreatitis fluids treatment

A

Ringers preferred, collloids, electrolyte, Glucose, plasma transfusion

60
Q

Which test is the most useful in ruling out pancreatitis

A

Snap CPL or FPL

61
Q

Abdominal CT is useful in a identifying

A

Pancreatic necrosis

62
Q

Cytology is associated with

A

Low complication rate

63
Q

Histopathology for pancreatitis should be done via

A

Laparotomy, laparascopy or necropsy

64
Q

First and only medication approved for management of acute pancreatitis in dogs

A

Panoquell - CA1

65
Q

What is important about fluid therapy in pancreatitis management

A

Do not give excess

66
Q

In dogs what should you feed for management of pancreatitis

A

Fat restricted foods

67
Q

Butorphanol is good for pancreatitis?

68
Q

Why is morphine not great for pancreatitis

A

Induce vomiting

69
Q

Antiemetics for pancreatitis

A

Maroptiant, ondansetron , metoclopramide

70
Q

What is appetite stimulant

A

Entice, Miratazpine , gapabentin in cats

71
Q

Panoquell CA 1

A

Blocks inflammation pathway associated with acute pancreatitis by blocking neutrophil extra as ion

72
Q

Are antibiotics indicative for pancreatitis

A

If they are septic and that is it

73
Q

Why should u avoid NSAIDS in pancreatitis

A

Decrease perfusion of splanchnic organs and pancreatic hypoexmia can worsen pancreatitis

74
Q

What is the tria in cats

A

Pancreatitis, hepatitis, and IBD

75
Q

What are potiental risk factors for pancreatitis in cats

A

Biliary and chronic inflammatory enteropathy

76
Q

Is obesity, fat meals and dietary indiscretion associate with acute pancreatitis in cats

77
Q

Clinical manifestation of acute pancreatitis in cats

A

Anorexia and lethargy

78
Q

What is the most sensitive and specific blood test for pancreatitis n cats

79
Q

Radiographs and ultrasound in cats versus dogs for pancreatitis is

A

Lower sensitivity

80
Q

With Chronic pancreatitis what may occur due to destruction of the endocrine and exocrine pancreas

A

Diabetes Mellitus and EPI

81
Q

EPI

A

Syndrome of nutrient meal digestion resulting from deficiency of pancreatic acinar functions

82
Q

What is the most common cause of EPI in dogs

A

Pancreatic acinar atrophy

83
Q

Recurrent/ chronic pancreatitis can lead to

84
Q

Pathophysiology of EPI

A

Lack enzymes to break down nutrients, leads to osmotic diarrhea from SI, malnutrition, weight lost, and polyphasic

85
Q

EPI causing an increase substrate matter often causes

86
Q

What definicency is common with EPI

87
Q

Clinical signs of EPI are not seen until

A

90% of exocrine function is lost

88
Q

What breed is at an increased risk of EPI

A

German shepherds

89
Q

C/S of EPI

A

Weight loss, polyphasic, coprophagia, undigested food, Pica

90
Q

Gold standard for diagnosing EPI

A

Serum trypsin like immunoreactivity

91
Q

What value should u measure for EPI

A

Cobalamin - it will be deficient if positive

92
Q

How do you treat EPI

A

Digestive enzymes and vitamin B12

93
Q

What type of food trial can be done with a dog you suspect has EPI

A

Highly digestible, moderate fat, low fiber

94
Q

What is prognosis of EPI

95
Q

Clinical mainfestion of EPI is seen in

96
Q

What fraction of cats have the trifecta of EPI

97
Q

With EPI you have impaired

A

Mucosal and brush border enzymes and transporters

98
Q

Cobalamin is produced by what in dogs

A

Pancreas and stomach

99
Q

Coblamanin is produced by what in cats

100
Q

Chronic pancreatitis is more common in

101
Q

What are 3 causes of EPI

A

Acinar atrophy, chronic pancreatitis, and adenocarinoma of pancreas

102
Q

Is a biopsy indicative of EPI

103
Q

What TLI is diagnostic for EPI

104
Q

What is sign of too much supplement enzymes

105
Q

What can u feed for EPI treatment

A

Frozen pork pancreas

106
Q

What are typical signs in cat with EPI

A

Weight loss and greasy coat

107
Q

How much powdered enzymes is given to dog with EPI

A

2 teaspoons per 20 kg

108
Q

How often do u feed raw pork pancreas to dog with EPI

109
Q

How much enzymes do u give to cat with EPI

A

1/2 - 1 teaspoon per meal

110
Q

How much raw pancreases do u feed cat

A

25 - 50 gram raw pancreas per meal

111
Q

What percent has weight loss in cats with EPI

112
Q

What TLI is didagnost in cat

A

Less than 8

113
Q

What to do if you get 8 - 12 in TLI in cats

A

Repeat in 1 month

114
Q

TLI is higher in what type of cat

115
Q

Cats should be fasted for how long before TLI

116
Q

What is 100% specific in cats for TLI

117
Q

What is grey zone for TLI in dogs

118
Q

What is greater than 5 in TLi in dogs mean

119
Q

2 types of pancreatic neoplasia to consider

A

Adenocarcinma and insulinoma

Alimentary (14 decks)

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