122 Biliary and pancreatic function

Question 1

Which cells of the pancreas produce bicarbonate?

Answer 1

Duct cells

Question 2

Which cells of the pancreas make trypsin?

Answer 2

Acinar cells

Question 3

Which hormones to the islet cells of the pancreas secrete? (4 listed)

Answer 3

1. insulin
2. glucagon
3. pancreatic polypeptide
4. somatostatin

Question 4

Which parasympathetic nerves are found in the sensory duodenum?

Answer 4

Vagal sensory nerves

Question 5

Name the 2 main bile acids

Answer 5

• Cholic acid
• chenocholic acid

Question 6

What is the daily dietary intake of lipids

Answer 6

100g/day

Question 7

Name the 2 essential acids required by the body

Answer 7

• linoleic acid
• linolenic acid

Question 8

What reaction does cholesterol esterase catalyse?

Answer 8

Cholesterol ester –> FA’s and cholesterol

Question 9

Which enzyme catalyse the formation of lysolecithin and FA from lecithin?

Answer 9

Phospholipase

Question 10

Which enzyme optimises lipase activity?

Answer 10

Colipase

Question 11

Which aa’s do bile acids conjugate with to form bile salts?

Answer 11

• glycine

OR

• taurine

Question 12

What does 7α-hydroxylase convert cholesterol to?

Answer 12

Cholic acid

Question 13

Which protein carries bile acids in the portal venous blood?

Answer 13

albumin

Question 14

How much bile salts are secreted from the liver to the duodenum daily?

Answer 14

15-30g

Question 15

How much bile salts are synthesised by the liver daily?

Answer 15

0.5g –> this is how much is lost in faeces daily

Question 16

Where are RBCs degraded?

Answer 16

Reticuloendothelial system in the spleen and liver macrophages

Question 17

What is the role of heme oxygenase?

Answer 17

Converts heme to bilirubin

Question 18

Where does lipid soluble unbound bilirubin go to in the body?

Answer 18

Brain

Question 19

What is the role of bilirubin glucuronyl transferase?

Answer 19

• adds 2 molecules of glucuronic acid to bilirubin making it more soluble
• needs to be conjugated to allow access into hepatocytes

Question 20

What is stercobilin?

Answer 20

Gives brown discolouration to poo and is oxidised from urobilinogens by intestinal bacteria

Question 21

What is urobilinogen produced from?

Answer 21

Bilirubin glucuronide

Question 22

How can the exocrine function of the pancreas be tested?

Answer 22

• serum amylase
  
  • >3 = acute pancreatitis
• Faecal elastase
• Faecal fat
  
  • directly measures pancreatic enzyme activity

Question 23

Which type of Ca commonly affects the pancreas?

Answer 23

Adenocarcinoma

Question 24

What does a mutation in cationic trypsinogen gene lead to?

Answer 24

Hereditary pancreatitis - predisposes to pancreatic Ca - adenocarcinoma from ductal cells

Question 25

Which vitamins are deficient in pancreatic insufficiency?

Answer 25

• A
• D
• E
• K