2C anatomy, physiology and pathology of the pancreas

Question 1

the production of insulin and glucagon; plasma glucose regulation

Answer 1

endocrine pancreas

Question 2

involved in the production of pancreatic juice

Answer 2

exocrine pancreas

• source of HCO3-
• source of many digestive enzymes

Question 3

pancreatic juice travels from the pancreas to the duodenum via the

Answer 3

main pancreatic duct

Question 4

how much pancreatic juice is produced each day

Answer 4

1500ml

Question 5

what is the avarage pH in the duodenum

Answer 5

pH of 6.0 - 7

Question 6

what are the 9 enzymes included in the pancreas juice

Answer 6

1) pancreatic amylase
2) pancreatic lipase
3) colipase
4) trypsinogen
5) chymotrypsinogen
6) procarboxypeptide
7) proelastase
8) ribonuclease
9) deoxyriboneclease

Question 7

where does bile originate from

Answer 7

liver or the kidney

Question 8

proteases of the pancreatic juice are secreted as ______ ______

Answer 8

inactive “pro-enzymes”

Question 9

trypsinogen is converted to the active enzyme _______ by the brush border enzyme _______ when the pancreatic juice enters the duodenum

Answer 9

Trypsin, enterokinase (also known as enteropeptidase)

Question 10

trypsin converts chymotrypsinogen into active _________, Procarboxypeptidase into active ________ and proelastase into ________

Answer 10

chymotrypsin, carboxypeptidases, elastase

Question 11

enterokinase deficiency can occur as a ______ ______ which leads to ________ _________

Answer 11

congenital abnormality, protein malnutrition

Question 12

why are trypsin inhibitors necessary

Answer 12

in case trypsin is activated within the pancreas

Question 13

what two hormones are the main control of secretion of pancreatic juice

Answer 13

secretin and CCK

Question 14

what is used to diagnose acute pancreatitis

Answer 14

measurement of the plasma pancreatic amylase of pancreatic lipase (inflammation of necrosis of pancreatic acinar cells)

Question 15

what do most cases of pancreatitis result from

Answer 15

Gallstones or alcohol abuse

Question 16

fat necrosis is a symptom of what

Answer 16

enzyme autodigestion that produce fatty deposits in the abdominal cavity with hemorrhage from the necrotic vessels

Question 17

what is the most common initial symptom of pancreatitis

Answer 17

severe epigastric and abdominal pain and radiates to the back

Question 18

what is the most common symptom in patients with exocrine pancreatic cancer

Answer 18

pain, jaundice, weight loss

Question 19

where are the mojority of pancreatic cancers located

Answer 19

60-70% are localized to the head of the pancreas

20-25% are in the bady and tail, rest involves the whole pancreas

Question 20

what are the three major risk factors for pancreatic cancer

Answer 20

• cigarette smoking
• high body mass and lack of physical activity
• history of chronic pancreatitis

Question 21

what percentage of patients with pancreatic cancer have familial aggregation (first degree relative

Answer 21

5-10%

Question 22

what is the most common lethal genetic diseases among whites

Answer 22

cystic fibrosis

Question 23

what causes cystic fibrosis

Answer 23

defect of Cl- channels due to the metation inf the cystic fibrosis transmambrane conductance regulator gene

Question 24

what are the clinical manifestation of cystic fibrosis

Answer 24

• chronic pulmonary disease
• pancreatic insufficiency
• miconium ileus

Question 25

how is cyctic fibrosis diagnosed

Answer 25

sweat test