2C-"We ate Pancreas!" Flashcards

1
Q

What does pancreas endocrine function refer to?

A

Insulin and Glucagon

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2
Q

What does pancreas exocrine function refer to?

A

Pancreatic Juice

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3
Q

What are the 2 GENERAL contents of pancreatic juice? What is the pH?

A

1.HCO3 2.Digestive Enzymes(9)…pH of 7.6 to 8.2-Alkaline to balance stomach acid

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4
Q

What are the three anatomical divisions of the pancreas? Which division is closest to the Duodenum?

A

Tail, Body, and Head (next to Duodenum)

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5
Q

What are the two main cell groups of the pancreas? What % composition?

A

1.Islets of Langerhans (endocrine)-5% 2.Ascinar cells (exocrine cells)-95%

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6
Q

How does pancreatic juice travel from the pancreas to the duodenum?

A

The main pancreatic duct

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7
Q

Review: How much Pancreatic Juice is produced per day?

A

1.5 L

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8
Q

What 2 juices, along with pancreatic juice, are neutral or alkaline to bring the Duodenum pH to 6.0-7.0?

A

Bile and Intestinal Juice

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9
Q

What is the INFAMOUS region where the Bile Duct Sphincter, the Pancreatic Duct Sphincter, and the Sphincter of Oddi all join together?

A

the Papilla of Vater (NOT darth Vader)

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10
Q

BOOM: WHAT ARE THE 9, yes NINE, Enzymes of the Pancreatic Juice??!!

A

1.Pancreatic Amylase 2.Pancreatic Lipase 3.CoLipase 4.Trypsinogen 5.Chymotrypsinogen 6.Procarboxypeptidase (A/B) 7.Pro-Elast-ase 8.RiboNuclease 9.DeOxyRiboNuclease

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11
Q

What are the proteases of the pancreatic juice secreted as?

A

Inactive “pro-enzymes”

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12
Q

What converts Trypsinogen to Trypsin? Where does this happen?

A

EnteroKinase(EnteroPeptidase)..At the entrance of the Duodenum

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13
Q

What are the three proteases that Trypsin converts from inactive to active forms?

A

1.Chymotrypsinogen—>Chymotrypsin 2.ProCarboxyPeptidase—->CarboxyPeptidase 3.Pro-elastase—>Elastase

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14
Q

_________ deficiency can occur as a congenital abnormality, which leads to protein malnutrition.

A

Enterokinase

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15
Q

What does Pancreatic tissue keep up its sleeve to keep its enzymes from digesting itself?

A

Trypsin Inhibitors!

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16
Q

What are the two hormones controlling pancreatic juice secretion? What are their products like?

A

1.Secretin-Pancreatic Juice that’s RICH in HCO3- and LOW in enzymes. 2.CCK-Pancratic Juice that’s Rich in enzymes and Low in HCO3-

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17
Q

What CN stimulates secretion of pancreatic juice? How does this juice compare to to Secretin/CCK? What triggers this CN response?

A

VAGUS X! A juice rich in enzymes, but not as much as CCK. The SIGHT or SMELL of food can trigger this!

18
Q

___________ is a severe, life-threatening disorder associated with the escape of activated pancreatic enzymes into the pancreas and surrounding tissues.

A

Acute pancreatitis

19
Q

Measurement of the plasma _________ or __________ is therefore of value in diagnosing problems associated with inflammation and necrosis of pancreatic acinar cells.

A

pancreatic amylase or pancreatic lipase

20
Q

In pancreatitis, these enzymes cause _______, or “_______” of the pancreas and produce fatty deposits in the abdominal cavity with hemorrhage from the necrotic vessels.

A

fat necrosis or “auto digestion”

21
Q

What are the two main causes for Pancreatitis?

A

1.Gallstones in the common bile duct 2.EtOH

22
Q

What are the two pancreas results of Alcohol?

A

1.EtOH is a POTENT pancreatic secretion stimulator 2.Contraction of the Sphincter of Oddi

23
Q

LISTS! What 6 things is Acute Pancreatitis also associated with?

A

1.HyperLipidEmia 2.HyperParathyroidism 3.Viral Infections 4.Abdominal/Surgical Trauma 5.Drugs-STEROIDS 6.Thiazide Diuretics

24
Q

What is the most common initial symptom of Pancreatitis?

A

SEVERE Epigastric and Abdominal Pain radiates to the Back that is bad in a SUPINE position!

25
Q

What condition is associated with abdominal distention accompanied by hypoactive (soft) bowel sounds?

A

Pancreatitis

26
Q

Mild _______ may appear after the first 24 hours because of biliary obstruction in pancreatitis.

A

jaundice

27
Q

An important disturbance related to acute pancreatitis is the loss of a large _________ into the abdominal cavity.

A

volume of fluid

28
Q

Tachycardia, hypotension, cool and clammy skin, and fever often are evident in _________.

A

Acute Pancreatitis

29
Q

Signs of hypocalcemia may develop in acute pancreatitis, probably as a result of the precipitation of serum calcium in the areas of ________.

A

fat necrosis

30
Q

The commonly used term “pancreatic cancer” usually refers to a _____________ of the pancreas (including its subtypes).

A

ductal adenocarcinoma

31
Q

More than 95% of malignant neoplasms of the pancreas arise from the ________ elements and are referred to as “____________”.

A

exocrine…“exocrine pancreatic cancers”

32
Q

What are the three most common presenting symptoms in patients with exocrine pancreatic cancer?

A

1.Pain 2.Jaundace 3.Weight

33
Q

The initial presentation of pancreatic cancer varies according to tumor location. Approximately 60-70% exocrine pancreatic cancers are localized to the ______ of the pancreas, while 20-25% are in the ________ and the remainder involve the whole organ. Compared to tumors in the body and tail of the gland, pancreatic head tumors more often present with _______, ________, and ________.

A

head…..body/tail…. jaundice, steatorrhea (Fat in stool) (not being digested), and weight loss (no food digested)

34
Q

___________ is the only potentially curative treatment for exocrine pancreatic cancer, but because of the late presentation of the disease, only ______% of patients are candidates for _________.

A

Surgical resection..15-20% ..pancreatectomy

35
Q

The prognosis of pancreatic cancer is poor. The five-year survival following pancreatico- duodenectomy is only about ______% for node-negative and _____% for node- positive tumors.

A

25-30%…10% (node positive means trouble)

36
Q

What are the 5 major risk factors for pancreatic cancer?

A

1.Cigarette Smoking 2.High Body Mass 3.Lack of Physical Activity 4.History of Chronic Pancreatitis 5.Genetic

37
Q

What is the most common LETHAL genetic disease among “whites”?

A

Cystic Fibrosis

38
Q

Cystic Fibrosis results from a defect in ________ that is caused by a mutation in the _______________(____) gene.

A

Cl- channels……cystic fibrosis transmembrane conductance regulator (CFTR)

39
Q

Characteristics of Cystic Fibrosis include malfunction of ______ glands, resulting in increased ______ of mucus and increased chloride concentration in _____ and _____.

A

exocrine….viscosity….sweat and tears

40
Q

What is the most important diagnostic procedure for Cystic Fibrosis?

A

The sweat test!

41
Q

What are the three clinical manifestations of Cystic Fibrosis?

A

1.Chronic Pulmonary Disease 2.Pancreatic Insufficiency 3.Meconium Ileus (thick stool blocking the ilium in a baby)