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Clinical Chemistry 1 > 11. Pancreatic Function > Flashcards

11. Pancreatic Function Flashcards

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1
Q

Major source of amylase?

A

Acinar cells of pancreas

Salivary glands

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2
Q

What is required for functional activation of amylase

A

Calcium

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3
Q

What is required for FULL activation of amylase

A

Anions

  • bromide
  • chloride
  • cholate (coenzyme)
  • nitrate
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4
Q

2 coupled enzymatic rxns to measure amylase?

A
  • NADH absorption

- Free NP absorption (RXL method)

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5
Q

Why is heparin the only anticoagulant that can be used for amylase samples

A

Others chelate Ca2+ required for amylase’s functional activation

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6
Q

3 diseases that cause 05% of medical problems associated w/ pancreas?

A
  • Acute pancreatitis
  • Chronic pancreatitis
  • Pancreatic carcinoma
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7
Q

Common causes of acute pancreatitis

A
  • heavy alcohol use
  • intra-abdominal diseases (intestinal obstruction, gallstones blocking common bile duct)
  • infections, tumors, trauma
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8
Q

What happens to pancreatic ducts when there’s chronic pancreatitis

A

Pancreatic ducts calcified, scar tissue builds up = malabsorption

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9
Q

Common causes of chronic pancreatitis

A
  • chronic alcohol abuse
  • autoimmune
  • genetic mutations due to CF
  • blocked pancreatic duct or common bile duct
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10
Q

What happens to AMY levels in chronic pancreatitis (initially, progress)

A

initially = elevated

declines as acinar tissue destroyed

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11
Q

3 other disorders that can cause elevated AMY?

A
  • Acute appendicitis
  • Salivary gland inflammation
  • Renal insufficiency
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12
Q

Reference method for lipase measurement?

A

Titrimetric

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13
Q

Serum and urine amylase levels in acute pancreatitis? (high/low)

A 
Serum = high
Urine = high
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14
Q

Serum and urine amylase levels in macroamylasemia? (High/low)

A 
Serum = high
Urine = low
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15
Q

What causes macroamylasemia

A

AMY binding to IgG and IgA = large macromolecule

Can’t be filtered

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16
Q

Amylase: Creatinine Clearance Ratio (ACCR) is used to diagnose what?

A

Macroamylasemia

17
Q

Almost all of the lipase

found in serum is derived from the ________

A

pancreas

18
Q

What do lipases hydrolyze?

A

Glycerol esters of triglycerides at ester bond to make glycerol + 3FA

19
Q

Full activity of lipases requires..?

A

Cofactors - bile salts (sodium glycocholate) and colipase (coenzyme)

20
Q

____ is effective in reducing lipase lag phase and activating it

A

Ca2+

21
Q

5 rxn methods for analyzing lipase

A
  • titrimetric
  • turbidimetric
  • spectrophotometric
  • fluorometric
  • immunological
22
Q

Why would hemolysis falsely lower lipase results

A

Hgb inhibits activity of serum lipase

23
Q

What can falsely increase lipase?

A

Drugs w/ high conc of free glycerol (colorimetric methods)

24
Q

2 reasons why elevated lipase cause decrease calcium?

A

Release of free fatty acids from lipase activity => FAs bind to Ca2+

Liapse needs bile calcium salts as cofactors

25
Q

What are the 4 types of lipids found in stool?

A
  • Triglycerides (neutral)
  • Fatty acid salts (soaps)
  • Fatty acids
  • Cholesterol
26
Q

Fecal fat analysis stain?

A

Oil red O

Sudan III dyes

27
Q

2 parts of fecal fat stain?

A
  • neutral fat stain

- split fat stain for FAs

28
Q

3 quantitative methods for fecal fat anaylsis

A
  • gravimetric
  • titrimetric
  • NMR spectroscopy
29
Q

Cause of pancreatic malabsorption or insufficiency in children? Adults?

A

Children - cystic fibrosis

Adults - acute pancreatitis

30
Q

How does CF affect pancreas

A

Thick sticky mucous obstructs pancreas passages

31
Q

4 amylase cofactors

A

Ca2+
Cl-
Br2+
NO3-

32
Q

Substrate for amylase

A

Carbohydrates w/ 1,3-4a-glycosidic linkages (e.g. starch, glycogen)

33
Q

Levels of amylase and lipase in chronic pancreatitis?

A

Increase in early stages

Declines as acinar tissue destroyed

34
Q

Enzyme most specific for acute pancreatitis?

A

Lipase (>5x RI = acute pancreatitis + rules out other conditions)

Clinical Chemistry 1 (13 decks)

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