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GI > Exocrine Pancreas > Flashcards

Exocrine Pancreas Flashcards

1
Q

Endocrine secretion

A

Insulin
Glucagon

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2
Q

Exocrine secretion

A

Bicarbonate
Enzymes

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3
Q

Pancreatic Islets

A

Alpha cells
Beta cells
To bloodstream

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4
Q

What do alpha cells secrete

A

Glucagon

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5
Q

What do beta cells secrete

A

Insulin

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6
Q

Acini cells

A

Secrete enzymes to pancreatic duct
Centrocinar cells
Ductable cells
CFTR channel

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7
Q

What do centrocinar cells produce

A

HCO3-

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8
Q

Function of ductable cells

A

HCO3- and Cl- exchange

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9
Q

Zymogen of trypsin

A

Trypsinogen

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10
Q

Zymogen of chymotrypsin

A

Chymotrypsinogen

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11
Q

Proteases released from the pancreas

A

Trypsin and chymotrypsin (in inactive form)

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12
Q

Where are proteases activated

A

Small intestine

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13
Q

What activates trypsinogen and chymotrypsinogen

A

Enterokinase

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14
Q

Where is enterokinase found

A

On epithelial cell walls

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15
Q

Function of proteases

A

Digests proteins and peptides (not to amino acids)

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16
Q

What activates trypsinogen

A

Enterokinase
Trypsin - positive feedback loop

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17
Q

Function of pancreatic lipase

A

Triglyceride digestion by hydrolysis to produce monoglycerides and free fatty acid chains

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18
Q

Steatorrhea

A

Fatty stools
Pancreatic insufficiency of pancreatic lipase

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19
Q

Function of amylase

A

Hydrolyses starch to maltose and dextrins

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20
Q

Pancreatic enzymes

A

Trypsin
Chymotrypsin
Pancreatic lipase
Amylase
Gelatinase
Elastase
Ribonuclease
Deoxyribonuclease

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21
Q

Primary pancreatic enzyme secretion

A

NaHCO3

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22
Q

Secondary pancreatic enzyme secretion

A

HCO3- is exchanged for Cl-

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23
Q

Fluid composition of enzyme secretions

A

Dependent of flow rate
The faster it flows the less exchange of HCO3- and Cl- so it is richer in HCO3- and lower in Cl-
Na+ and K+ levels do not change

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24
Q

Functions of pancreatic bicarbonate secretion

A

Protects duodenal mucosa by neutralising acid
Buffers duodenal contents
Optimises pH for enzyme digestion

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25
Q

Resting phase- bicarbonate secretion

A

Low flow
Predominantly Na+ and Cl-

26
Q

High flow bicarbonate secretion

A

Mainly Na+ and HCO3-

27
Q

Average flow of bicarbonate secretion per day

A

1 L

28
Q

Which nerve stimulates release of pancreatic enzymes

A

Vagus

29
Q

HCO3- rich component of pancreatic secretions

A

Mainly stimulated by production of acid in the stomach
Neutralising effect
Stimulated by secretin and CCK

30
Q

Which phase of gastric motility is most dominant in pancreatic enzyme secretion

A

Intestinal phase

31
Q

Enzymatic component of pancreatic secretion

A

Secreted from Acinar cells in response to an increased intracellular Ca2+ concentration
Produced by ACh from vagal stimulation
CCK secreted from small intestine can stimulate enzyme release

32
Q

Cholecystokinin stimulus

A

HCl
Proteins and fats in duodenum

33
Q

Production of cholecystokinin

A

I cells of duodenum and Jejunum

34
Q

Action of cholecystokinin

A

Pancreatic enzyme and HCO3- secretion
Gallbladder contraction- causing bile secretion
Inhibition of gastric acid secretion
Delays gastric emptying (aid digestion0

35
Q

Secretin stimulus

A

Low duodenal pH

36
Q

Secretin production

A

Upper small intestine

37
Q

Action of secretin

A

Pancreatic water and HCO3- secretion - carries the enzymes
Alllows enzymes to work in small intestine as it raises the pH

38
Q

Gastrin stimulus

A

Gastric distension and irritation

39
Q

Gastrin production

A

G cells in stomach

40
Q

Action of gastrin

A

HCl secretion (parietal cells)
Enzyme release (Acinar cells)

41
Q

Which cells secrete pancreatic enzymes

A

Acinar cells

42
Q

What causes Acinar cells to secrete pancreatic enzymes

A

Increased intracellular Ca2+ concentration

43
Q

What increases Ca2+ concentration in Acinar cells

A

ACh from vagal stimulation

44
Q

Orlistat

A

Pancreatic lipase inhibitor

45
Q

Enzyme secretion- Cephalic phase

A

Cephalic stage- vagal innervation
Low level stimulus in anticipation of a meal

46
Q

Enzyme secretion - intestinal stage

A

Secretin
Cholecystokinin
Gastrin

47
Q

Symptoms of pancreatic exocrine symptoms

A

Maldigestion
Diarrhoea
Steatorrhoea
Weight loss

48
Q

Pancreatic exocrine insufficiency prevalence

A

11000 adults/year in uk develop PEI

49
Q

Pancreatic exocrine insufficiency consequences

A

Malnutrition
Osteoporosis
Increased cardiovascular morbidity
Symptoms burden

50
Q

Pancreatic exocrine insufficiency - parenchymal diseases

A

Chronic pancreatitis
Acute pancreatitis
Cystic fibrosis
Pancreatic cancer
Autoimmune pancreatitis

51
Q

Pancreatic exocrine insufficiency - extra-pancreatic diseases

A

Coeliac disease
IBD
Diabetes
Zollinger-Ellison
Ampullary obstruction

52
Q

Pancreatic exocrine insufficiency

A

Reduction in pancreatic enzyme activity in the intestinal lumen below the threshold required to maintain normal digestion

53
Q

Pancreatic exocrine insufficiency - post surgical states

A

Gastric resection
Whipple’s
Short bowel syndrome
Post bariatric surgery

54
Q

Assessment of pancreatic function

A

History, risk factors
Imaging
Faecal elastase
Markers of malnutrition

55
Q

Treatment of Pancreatic exocrine insufficiency

A

Pancreatic enzyme replacement therapy
Stop smoking
Bone health assessment
Treat the underlying cause

56
Q

Pancreatic exocrine insufficiency mechanisms

A

Loss of parenchyma cells
Obstruction of secretion

57
Q

Type 3c diabetes

A

develops when your pancreas experiences damage, such as from chronic pancreatitis or cystic fibrosis.
People with Type 3c diabetes often also have a lack of pancreatic enzymes that are important for digestion.
Type 3c diabetes is manageable with oral diabetes medications and/or insulin.

58
Q

Which receptors activate pancreatic enzyme and bicarbonate secretion

A

M1 and M3 muscarinic receptors

59
Q

Which 2 enzymes are secreted from the pancreas in their active form

A

Amylase
Lipase

60
Q

Pepsin is an important digestive enzyme. Which of the following statements concerning pepsin is true?

A

It hydrolyses bonds between aromatic amino acids

GI (12 decks)

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