Exocrine and Endocrine Pancreas

Question 1

How do you detect Pancreatic injury?

Answer 1

Serum Amylase
Serum Lipase
Peritoneal fluid amylase/lipase
Trypsin-like Immunoreactivity (TLI)
Pancreatic Lipase immunoreactivity

Question 2

TLI

Answer 2

Trypsin-like Immunoreactivity

Question 3

Amylase levels that suggest Pancreatic injury

Answer 3

greater than 3-4x the upper end of normal

Question 4

Lipase levels that suggest Pancreatic injury?

Answer 4

greater than 2x upper end of normal

Question 5

What can increased Lipase levels?

Answer 5

Corticosteroids

Question 6

How much does Dexamethasone increase lipase levels?

Answer 6

Greater than 5x the normal limit

Question 7

Peritoneal fluid amylase/lipase

Answer 7

Highly suggestive of pancreatitis

Question 8

Which is probably more sensitive, Amylase or Lipase?

Answer 8

Lipase

Question 9

What does TLI measure?

Answer 9

Trypsinogen and Trypsin

Best Exocrine Pancreatic Insufficiency (EPI)

Question 10

What is pancreas-specific?

Answer 10

Trypsinogen

Question 11

PLI

Answer 11

Pancreatic Lipase Immunoreactivity

Question 12

What is a good prognostic test for acute pancreatitis?

Answer 12

C-reactive protein

Question 13

What other abnormalities are seen with Pancreatitis?

Answer 13

Hyperglycemia
Hypocalcemia
Increased Liver enzymes

Question 14

What does increased liver enzymes indicate?

Answer 14

Cholestasis
Hepatocyte necrosis
Pancreatitis

Question 15

What increases in horses with Pancreatitis?

Answer 15

Amylase

Question 16

What is the best test for pancreatitis in cats?

Answer 16

PLI

Question 17

What are the laboratory abnormalities associated with feline necrotizing pancreatitis?

Answer 17

Anemia
Hemoconcentration 
Neutrophilia
Neutropenia 
Increased ALT, AST
Increased ALP 
Increased Bilirubin
Increased glucose 
Increased Cholesterol
Decreased Calcium 
Decreased Albumin 
Lipemia 
Hypokalemia

Question 18

What are the sources of blood glucose?

Answer 18

Intestinal absorption
Hepatic Production
Kidney Production

Question 19

Where is Insulin secreted from?

Answer 19

Pancreatic islet Beta-cells

Question 20

What is the function of insulin?

Answer 20

Lower blood glucose
Promotes tissue uptake
inhibits liver gluconeogenesis
Promotes liver glycogen storage

Question 21

What is the most common reason for hyperglycemia?

Answer 21

Glucocorticoids

Question 22

What is the function of Glucocorticoids?

Answer 22

Increased Blood Glucose
Promote hepatic gluconeogenesis
Inhibit insulin binding
Inhibit insulin action

Question 23

What are the functions of catecholamines?

Answer 23

Increase blood glucose 
Increase hepatic glycogenolysis 
Inhibit insulin secretion 
stimulate glucagon secretion 
inhibit insulin action

Question 24

What secretes Glucaogon?

Answer 24

Pancreatic islet alpha-cells

Question 25

What is the function of Glucagon?

Answer 25

``` Increases blood glucose Increases hepatic gluconeogenesis Increases hepatic glycogenolysis Inhibits insulin binding inhibits insulin action ```

Question 26

What is the function of growth hormone?

Answer 26

Increasese blood glucose Inhibitis cellular glucose uptake Inhibits insulin action Increases hepatic gluconeogenesis

Question 27

What is apparent Hypoglycemia?

Answer 27

Glycolysis by erythrocytes due to failure to remove serum from clot within 30 mins

Question 28

What causes Hypoglycemia?

Answer 28

``` Increased insulin levels: Insulinoma and insulin overdose Sepsis Hepatic Failure: Decreased gluconeogenesis or glycogenolysis Juvenile/Neonatal hypoglycemia Ketosis/pregnancy toxemia Neoplasia Starvation/Malabsorption Extreme exertion Hypoadrenocorticism Xylitol ingestion in dogs Ackee fruit ingestion ```

Question 29

If Blood glucose is less than 60mg/dl...

Answer 29

Insulin should drop

Question 30

If Blood glucose is less than 60mg/dl and insulin is high

Answer 30

Insulinoma

Question 31

What causes Hyperglycemia?

Answer 31

``` Glucocorticoids Catecholamines Daibetes Mellitus Post-prandial Pancreatitis Hormone imbalance Ethylene glycol toxicosis Megestrol acetate in cats Milk fever in cattle Moribund animals Proximal duodenal obstruction ```

Question 32

What is the cause of Glucosuria?

Answer 32

Blood glucose has exceeded renal threshold | Renal tubular disorders

Question 33

What animals have proximal duodenal obstruction?

Answer 33

Ruminants

Question 34

Type I Diabetes mellitus

Answer 34

Immune mediated Beta-cell destruction No insulin production MAJOR FORM OF DM in DOGS!!

Question 35

Type II Diabetes Mellitus

Answer 35

Decreased insulin production Tissue insulin resistance MAJOR FORM OF DM in CATS!!

Question 36

What is used to diagnose Diabetes Mellitus?

Answer 36

Fructosamine

Question 37

What causes a false decrease in Fructosamine?

Answer 37

Hypoalbuminemia

Question 38

What can detect hyperglycemia over a longer period of time than Fructosamine?

Answer 38

Glycated Hemoglobin

Question 39

What are common laboratory abnormalities in diabetes mellitus?

Answer 39

``` Dehydration Glucosuria Ketonuria Osmotic diuresis Low Urine SpGr Electrolyte loss ```

Question 40

What causes Ketonemia and ketonuria?

Answer 40

altered lipid metabolism Starvation pregnancy toxiemia bovine ketosis

Question 41

What happens to Potassium and Phosphorus with lack of insulin?

Answer 41

Shifts from inside cells to ECF

Question 42

Treating with fluids and insulin can result in what?

Answer 42

Hypokalemia | Hypophosphatemia