Case 4 - Pancreas

Question 1

Pancreatic cancer usually arise in which part of the pancreas?

Answer 1

Head of pancreas

Question 2

How is the pancreatic tissue protected against auto digestion?

Answer 2

1) Restricting protease activation to the duodenum
2) Trypsin inhibitor, which is copackaged in the secretory granules with trypsinogen
3) The higher pH in the acini and duct system due to HCO 3 − secreted by the centroacinar and intercalated duct cells, which helps keep all the enzymes inactive

Question 3

What are the factors that cause a development of a secondary malignant growth at a distance away from the primary site of pancreatic cancer to happen easily?

Answer 3

1) Sparse connective tissue around the ducts
2) Vasculature of pancreas

These 2 factors may facilitate metastasis of pancreatic cancer

Question 4

When food enters the small intestine, exocytosis of pancreatic digestive enzymes from secretory granules is promoted by which hormone?

Answer 4

CCK ( Cholecystokinin )

Question 6

Pancreatic cancer occur because of the carcinoma of which type of cells ?

Answer 6

Duct cells

Question 7

Which enzyme activates trypsinogen ?

Answer 7

Enteropeptidases in the duodenum

Question 7

Exocrine secretion in the pancreas is regulated mainly by ?

Answer 7

1) Cholecystokinin

2) Secretin

Question 8

What is the endocrine component of pancreas ?

a) pancreatic islets
b) Centroacinar cells
c) protein secreting cells

Answer 8

a) pancreatic islets

Question 9

If the proenzymes may be activated and digest pancreatic tissues this would cause ?

Answer 9

Acute pancreatitis

Question 10

Name the digestive enzymes in the pancreas.

Answer 10

1) Protease
2) alpha amylase
3) lipases
4) Nuclease ( RNAase & DNAase )

Question 11

Which hormone promotes water and HCO 3−secretion ?

Answer 11

Secretin

Question 12

A 40-year-old Asian-Indian man presented with progressively worsening breathlessness for 10 days. There were no associated symptoms of cough, pleuritic chest pain or fever. Histological slides revealed progressive fibrosis in his tissues that lead to loss of pancreatic function ? What is an accurate diagnosis for his condition?

Answer 12

Chronic pancreatitis

Question 13

The two polypeptide hormones regulating pancreatic secretion are produced by?

Answer 13

Enteroendocrine cells of the small intestine