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RUSVM Clinical Pathology 2016 > Exocrine and Endocrine Pancreas > Flashcards

Exocrine and Endocrine Pancreas Flashcards

1
Q

How do you detect Pancreatic injury?

A 
Serum Amylase
Serum Lipase
Peritoneal fluid amylase/lipase
Trypsin-like Immunoreactivity (TLI)
Pancreatic Lipase immunoreactivity
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2
Q

TLI

A

Trypsin-like Immunoreactivity

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3
Q

Amylase levels that suggest Pancreatic injury

A

greater than 3-4x the upper end of normal

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4
Q

Lipase levels that suggest Pancreatic injury?

A

greater than 2x upper end of normal

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5
Q

What can increased Lipase levels?

A

Corticosteroids

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6
Q

How much does Dexamethasone increase lipase levels?

A

Greater than 5x the normal limit

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7
Q

Peritoneal fluid amylase/lipase

A

Highly suggestive of pancreatitis

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8
Q

Which is probably more sensitive, Amylase or Lipase?

A

Lipase

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9
Q

What does TLI measure?

A

Trypsinogen and Trypsin

Best Exocrine Pancreatic Insufficiency (EPI)

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10
Q

What is pancreas-specific?

A

Trypsinogen

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11
Q

PLI

A

Pancreatic Lipase Immunoreactivity

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12
Q

What is a good prognostic test for acute pancreatitis?

A

C-reactive protein

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13
Q

What other abnormalities are seen with Pancreatitis?

A

Hyperglycemia
Hypocalcemia
Increased Liver enzymes

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14
Q

What does increased liver enzymes indicate?

A

Cholestasis
Hepatocyte necrosis
Pancreatitis

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15
Q

What increases in horses with Pancreatitis?

A

Amylase

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16
Q

What is the best test for pancreatitis in cats?

A

PLI

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17
Q

What are the laboratory abnormalities associated with feline necrotizing pancreatitis?

A 
Anemia
Hemoconcentration 
Neutrophilia
Neutropenia 
Increased ALT, AST
Increased ALP 
Increased Bilirubin
Increased glucose 
Increased Cholesterol
Decreased Calcium 
Decreased Albumin 
Lipemia 
Hypokalemia
18
Q

What are the sources of blood glucose?

A

Intestinal absorption
Hepatic Production
Kidney Production

19
Q

Where is Insulin secreted from?

A

Pancreatic islet Beta-cells

20
Q

What is the function of insulin?

A

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

21
Q

What is the most common reason for hyperglycemia?

A

Glucocorticoids

22
Q

What is the function of Glucocorticoids?

A

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

23
Q

What are the functions of catecholamines?

A 
Increase blood glucose 
Increase hepatic glycogenolysis 
Inhibit insulin secretion 
stimulate glucagon secretion 
inhibit insulin action
24
Q

What secretes Glucaogon?

A

Pancreatic islet alpha-cells

25
Q

What is the function of Glucagon?

A 
Increases blood glucose 
Increases hepatic gluconeogenesis 
Increases hepatic glycogenolysis
Inhibits insulin binding 
inhibits insulin action
26
Q

What is the function of growth hormone?

A

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

27
Q

What is apparent Hypoglycemia?

A

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

28
Q

What causes Hypoglycemia?

A 
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
29
Q

If Blood glucose is less than 60mg/dl…

A

Insulin should drop

30
Q

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

A

Insulinoma

31
Q

What causes Hyperglycemia?

A 
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
32
Q

What is the cause of Glucosuria?

A

Blood glucose has exceeded renal threshold

Renal tubular disorders

33
Q

What animals have proximal duodenal obstruction?

A

Ruminants

34
Q

Type I Diabetes mellitus

A

Immune mediated Beta-cell destruction
No insulin production

MAJOR FORM OF DM in DOGS!!

35
Q

Type II Diabetes Mellitus

A

Decreased insulin production
Tissue insulin resistance

MAJOR FORM OF DM in CATS!!

36
Q

What is used to diagnose Diabetes Mellitus?

A

Fructosamine

37
Q

What causes a false decrease in Fructosamine?

A

Hypoalbuminemia

38
Q

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

A

Glycated Hemoglobin

39
Q

What are common laboratory abnormalities in diabetes mellitus?

A 
Dehydration 
Glucosuria
Ketonuria 
Osmotic diuresis 
Low Urine SpGr
Electrolyte loss
40
Q

What causes Ketonemia and ketonuria?

A

altered lipid metabolism

Starvation
pregnancy toxiemia
bovine ketosis

41
Q

What happens to Potassium and Phosphorus with lack of insulin?

A

Shifts from inside cells to ECF

42
Q

Treating with fluids and insulin can result in what?

A

Hypokalemia

Hypophosphatemia

RUSVM Clinical Pathology 2016 (22 decks)

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