Diseases of the Exocrine Pancreas

Question 1

what do acinar cells do?

Answer 1

synthesize and secrete catalytic digestive enzymes

Question 2

what are pacinian corpuscles?

Answer 2

normal pancreatic structures
mechanoreceptors related to sympathetic nerve endings in feline pancreas

Question 3

what is acinar degeneration and atrophy due to?

Answer 3

local/systemic diseases: starvation, ductal obstruction, fibrosis

Question 4

what is the most common cause of exocrine pancreatic insufficiency in dogs?

Answer 4

canine juvenile pancreatic atrophy

Question 5

what clinical signs are associated with canine juvenile pancreatic atrophy?

Answer 5

diarrhea
steatorrhea
weight loss with voracious appetite
poor hair coat
when 90% of secretory capacity is lost

Question 6

what is seen in the early stages of canine juvenile pancreatic atrophy (histology)?

Answer 6

intense T cell infiltration

Question 7

what is acute canine pancreatitis like?

Answer 7

primarily necrotizing with reactive inflammation

Question 8

what is chronic pancreatitis like?

Answer 8

primarily mononuclear

Question 9

what is acute pancreatitis like in cats?

Answer 9

acute suppurative pancreatitis secondary to ascending bacterial infection

Question 10

what is the pathogenesis of acute necrotizing pancreatitis?

Answer 10

inappropriate enzymatic activation/release and tissue autodigestion

Question 11

what is the disease progression of acute necrotizing pancreatitis?

Answer 11

necrosis and saponification of peripancreatic mesenteric fat
necrosis of marginal acini
necrosis and reactive inflammation at periphery of affected lobules

Question 12

what are the systemic consequences of acute necrotizing pancreatitis (release of proinflammatory mediators)?

Answer 12

acute hepatitis/hepatic necrosis
peritonitis
widespread vasculitis/thrombosis
hemorrhage
hypovolemic shock
DIC

Question 13

what are the outcomes of acute necrotizing pancreatitis?

Answer 13

uncomplicated resolution
healing by fibrosis
abscessation
chronic, unresolved inflammation
bystander destruction of islets

Question 14

what is the pathogenesis of chronic lymphocytic pancreatitis?

Answer 14

recurrent or unresolved bouts of pancreatic necrosis often with ductal obstruction
fibrosis, lymphoplasmacytic inflammation, atrophy

Question 15

what flukes inhabit pancreatic ducts?

Answer 15

Eurytrema
Dicrocoelium

Question 16

what are some proliferative lesion of the exocrine pancreas?

Answer 16

nodular acinar hyperplasia
adenoma
(adeno)carcinoma

Question 17

what does nodular acinar hyperplasia look like?

Answer 17

multiple, variably-ssized discrete nodules throughout parenchyma
non-encapsulated, no compression of surrounding parenchyma

Question 18

does nodular acinar hyperplasia cause compression of surrounding parenchyma?

Answer 18

no

Question 19

what are the two neoplasms of the exocrine pancreas?

Answer 19

adenoma
(adeno)carcinoma

Question 20

does an adenoma compress adjacent parenchyma?

Answer 20

yes

Question 21

is an (adeno)carcinoma usually solitary and discrete or multiple?

Answer 21

solitary, discrete, circumscribed mass usually

Question 22

what do islet cell tumors do?

Answer 22

functional: produce/secrete multiple hormones

Question 23

what is the most common neoplasm of the endocrine pancreas that is identified?

Answer 23

insulinoma

Question 24

what is paraneoplastic alopecia like?

Answer 24

symmetric ventral smooth, shiny skin in felines with pancreatic carcinoma

Question 25

when might you see neuroglycopenia?

Answer 25

inculinoma

Question 26

what is autolysis?

Answer 26

rapid postmortem release of digestive enzymes

Question 27

what can acinar degeneration and atrophy be due to?

Answer 27

starvation ductal obstruction fibrosis

Question 28

what are the causes of exocrine pancreatic insufficiency?

Answer 28

canine juvenile pancreatic atrophy pancreatitis necrosis toxic injury infection ductal disease neoplasia

Question 29

what is exocrine pancreatic insufficiency?

Answer 29

congenital/acquired depletion of acinar tissue

Question 30

what is triaditis?

Answer 30

IBD suppurative cholangitis suppurative pancreatitis

Question 31

what happens with trypsinogen in acute necrotizing pancreatitis?

Answer 31

activated by premature intracellular fusion of lysosomes with zymogen granules

Question 32

what is important in the inciting causes of acute necrotizing pancreatitis?

Answer 32

hypoperfusion/reperfusion

Question 33

what is the importance of chronic lymphocytic pancreatitis?

Answer 33

usually incidental if clinical: anorexia, vomiting, weight loss

Question 34

what is superficial necrolytic dermatitis related to?

Answer 34

glucagonoma