Ch. 37: Alterations in Function of the Gallbladder and Exocrine Pancreas Flashcards
The gallbladder is most accurately described as
A. The The source of urea
B. The storage site for fat and minerals
C. The duct that drains the tail of the pancreas
D. A distensible sack that concentrates and stores bile
D. A distensible sack that concentrates and stores bile
The principal function of the gallbladder is the concentration and storage of bile. Urea is formed by the kidneys and found in urine. The gallbladder is not associated with the storage of either fat or minerals. The dorsal pancreatic ductal system drains the tail of the pancreas.
During ingestion of a meal, contraction of the gallbladder is thought to be regulated by
A. Gastric pH
B. Circulating bile
C. Blood lipid levels
D. Hormonal control
D. Hormonal Control
Hormonally and possibly neurally regulated contraction of the gallbladder occurs, releasing the concentrated bile into the duodenum. Gastric pH, circulating bile, and blood lipid levels are not believed to be regulators of gallbladder contraction.
Most gallstones among patients in the United States are formed from
A. Pigment polymers
B. Cholesterol
C. Calcium
D. Sulfur
B. Cholestrol
Most gallstones among patients in the United States are cholesterol stones formed from precipitates of supersaturated bile. Stones form around aggregated cholesterol crystals. Only about 25% of gallstones in Western countries are due to pigment stones, which contain a mixture of pigment polymers and calcium salts. Sulfur is not a commonly seen mineral in gallstones.
Which characteristic is found in the condition of cholelithiasis (gallstones)?
A. The presence of gallstones universally creates colicky symptoms.
B. Gallstones are twice as frequent in women as in men.
C. Gallstones can be treated only through surgery.
D. Asians are at highest risk for gallstones.
B. Gallstones are twice as frequent in women as in men.
Gallstones are twice as frequent in women as in men. Gallstones may be found in individuals who are completely asymptomatic. Gallstones frequently require no treatment; on the other hand, they may cause inflammation and distress. High prevalence is seen in some racial groups, such as Pima Indians. Asians are at the lowest risk.
Cholecystitis is caused by
A. A fatty diet
B. Chronic gastritis
C. Spicy food intake
D. Inflammatory reactions
D. Inflammatory reactions
The term cholecystitis refers to inflammation of the gallbladder wall. The continued presence of gallstones within the gallbladder ultimately promotes inflammatory changes in the gallbladder wall, with fibrosis and thickening. A fatty diet doesn’t cause cholecystitis, but can aggravate the condition. Chronic gastritis is not associated with cholecystitis. Spicy food may not be tolerated well, but that is not the cause of cholecystitis.
Regarding both acute and chronic cholecystitis, which statement is true?
A. Chronic cholecystitis is often caused by fever and bacterial infection, whereas acute cholecystitis is not.
B. Rupture of the gallbladder is more likely to occur with acute rather than chronic cholecystitis.
C. Mild jaundice is more likely to be seen in chronic cholecystitis than in acute cholecystitis.
D. Symptoms of chronic cholecystitis generally occur after a meal.
B. Rupture of the gallbladder is more likely to occur with acute rather than chronic cholecystitis.
If left untreated, the inflammatory process of acute cholecystitis will escalate, and rupture of the gallbladder may occur. Chronic cholecystitis is thought to be caused by chronic inflammation of the gallbladder from persistent low-grade irritation from gallstones or by recurrent attacks of acute cholecystitis. Similar laboratory findings are seen (leukocytosis, mild jaundice, and occasionally, elevated amylase levels). The chief complaint of patients with chronic cholelithiasis is biliary colic, a persistent epigastric or right upper abdominal pain that may occur after a meal or spontaneously in the middle of the night.
What component of bile helps keep cholesterol from precipitating into crystals?
A. Bile acids
B. Fatty acids
C. Lecithin
D. Choline
C. Lecithin
Lecithin is an important part of bile that helps keep cholesterol from precipitating into crystals that may initiate gallstone formation. The relative concentrations of bile acids appear to determine the likelihood of cholesterol gallstone formation. Research shows that fatty acids reduce inflammation and may help lower risk of chronic diseases such as heart disease, cancer, and arthritis. Omega-3 fatty acids are highly concentrated in the brain and appear to be important for cognitive (brain memory and performance) and behavioral function. Choline, a nutrient in the B vitamin family, shows signs of being quite important to our early development, and all through our lives in our brains and livers.
The most serious consequence of acute pancreatitis resulting from biliary obstruction is
A. Reoccurring episodes of hypoglycemia
B. The development of circulatory shock
C. Its conversion to chronic pancreatitis
D. Stimulation of pancreatic proenzymes
B. The development of circulatory shock
Circulatory shock can occur and is a life threatening complication. While hypoglycemia is a serious problem, there is a risk for a more serious outcome. Inflammation of the gland rarely progresses to chronic pancreatitis. While acute pancreatitis stimulates pancreatic proenzymes to active forms that can lead to autodigestion, there is a risk for a more serious outcome.
The primary aim of treatment of acute pancreatitis is to
A. Prevent a fall in blood glucose
B. Reduce pancreatic secretion
C. Preserve enzyme secretion
D. Maintain oral intake
B. Reducing pancreatic secretion
Treatment of acute pancreatitis is aimed at reducing pancreatic secretion. Stabilizing blood glucose levels is important but not the primary aim of treatment of acute pancreatitis. Preserving enzyme secretion is not the primary aim of treatment of acute pancreatitis. Oral intake is contraindicated in the treatment of acute pancreatitis.
Which serum enzyme is the most specific for diagnosing acute pancreatitis?
A. Lipase
B. Amylase
C. Aminotransferase
D. Glutamic-oxaloacetic transaminase
A. Lipase
In acute pancreatitis, serum lipase and serum amylase rise in tandem during the first 12 hours and remain elevated for several days. However lipase is more specific and persists longer; it has therefore become the preferred test for more clinicians. While amylase rises in response to pancreatitis, it is less specific than another provided option. Aminotransferase is any of various enzymes that catalyze the transfer of an amino group between an alpha-amino acid and usually a specific carbon on a keto acid. Also called aminopherase (transaminase). An enzyme found in the liver, heart, and other tissues. A high level of serum glutamic-oxaloacetic transaminase released into the blood may be a sign of liver or heart damage, cancer, or other diseases. Also called aspartate transaminase and SGOT.
Acute necrotizing pancreatitis raises the threat of what devastating sequela?
A. Multisystem organ dysfunction
B. Diabetes with neuropathy
C. Bowel obstruction
D. Cerebral edema
A. Multisystem organ dysfunction
Severe pancreatitis with acute necrotizing pancreatitis may result in multisystem organ dysfunction, requiring aggressive support in the intensive care unit setting. Impaired function of the pancreas not pancreatitis can result in diabetes. Bowel obstructions and cerebral edema are not related to pancreatitis.
The chronic inflammatory lesions in the pancreas and persistence of symptoms seen in chronic pancreatitis are most frequently the complications of
A. Idiopathic causes
B. Hereditary factors
C. Hyperparathyroidism
D. Alcohol consumption
D. Alcohol consumption
Chronic pancreatitis is most often associated with alcohol consumption, although a small percentage of cases are idiopathic, hereditary, or associated with hyperparathyroidism (hypercalcemia), trauma, or various other factors. Only a small percentage of chronic pancreatitis is associated with idiopathic causes, hereditary factors, or associated with hyperparathyroidism (hypercalcemia), trauma, or various other factors.
The treatment for chronic pancreatitis is primarily directed toward which of the following? (Select all that apply.)
A. Treatment of endocrine insufficiency
B. Pancreatic enzyme replacement
C. Prevention of complications
D. Draining of the biliary tree
E. Pain relief
A. Treatment of endocrine insufficiency
C. Prevention of complications
E. Pain relief
The treatment of acute pancreatitis includes the treatment of exocrine and endocrine insufficiency, prevention of complications, and pain control. Pancreatic enzyme reduction, not replacement, is a component of care. Biliary tree drainage is not a component of care.
