Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Emma GI > Exocrine Pancreas, Acute/Chronic Pancreatitis > Flashcards

Exocrine Pancreas, Acute/Chronic Pancreatitis Flashcards

1
Q

most comm cause of acute pancreatitis

A

gallstones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

pancreatic juice

A

digestive enzymes

bicarbonate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

pancreatic acinar cells

A

secrete enzymes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

pancreatic epithelial ductal cells

A

secrete bicarb

modify fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

+ regulators of inc fluid/HCO3-from ductal cells

A

secretin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

+ regulators of enzyme release

A

vagal ACh

CCK

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

CCK

A

secreted by enteric I cells of duodenum

strongly stim by presence of partially digested proteins/fats in SI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

As chyme floods into SI, ___ is released into blood and binds to receptors on pancreatic acinar cells –> digestive enz release

A

As chyme floods into SI, CCK is released into blood and binds to receptors on pancreatic acinar cells –> digestive enz release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

pancreatic protease activation

A

takes place in SI

trypsinogen comes in contact w/ enteropeptidase –> TRYPSIN

trypsin cleaves all inactive proteases to their active forms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

proteins are cleaved by proteases into

A

peptides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

pancreatic lipase

A

digests triglycerides into 2-monoglyceride + 2 FFAs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

alpha-amylase

A

hydrolyses starch to simple sugars

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

cellulose

A

NOT metabolized by vertebrates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

secretin is secreted from

A

S-cells in response to acid-laden chyme coming from stomach–> duodenum

effect: stim pancreas ductal cells to secrete copious amounts of water and HCO3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

vasovagal reflex

A

vagus nerve increases enzyme release from acinar cells

stim by peptides/amino acids, fats, H+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

pancreas divisum

A

dorsal and ventral ducts do not fuse

2 separate ducts

  • accessory –> drains majority of pancreas
  • second ventral duct persists

may cause pancreatitis

*can be a normal variant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

acute pancreatitis

A

AUTODIGESTION via activated pancreatic enzymes

inflammation, necrosis, cytokines (SIRS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

causes of acute pancreatitis must

A

-stimulate pancreatic enzyme synthesis
AND
-block secretion from acinar cells
-EtOH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

complications of severe acute hemorrhagic pancreatitis

A
  • peripancreatic fat necrosis
  • abd/systemic fat necrosis
  • hemorrhage into parenchyma
  • hypOcalcemia
  • shock
  • ARDS/DAD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

T/F

gallstones cause both acute and chronic pancreatitis

A

F

gallstone pancreatitis is acute only (either recover or die)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

T/F

alcohol causes both acute and chronic pancreatitis

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

AI or Sclerosing Pancreatitis

A
  • subacute sx
  • acute pancreatitis
  • irregular, narrowed (beaded) pancreatic duct
  • periductal inflammation and fibrosis
  • elevated IgG4
  • steroid responsive
  • type I and II
  • may mimic pancreatic cancer
23
Q

hypertriglyceridemic pancreatitis

A
  • rare cause of acute pancreatitis
  • serum triglycerides usu >1000 mg/dL
  • may cause chronic disease
  • can be drug-induced
24
Q

drugs that may induce hypertriglyceridemic pancreatitis

A

alcohol
estrogens
isotretinoin
HIV-protease inhibitors

25
Q

which enzyme is most sensitive for acute pancreatitis dx?

A

lipase

26
Q

circulatory complications of acute pancreatitis

A

circulatory shock

  • hypOtension
  • hemoconcentration as plasma fluids leak into tissues
27
Q

acute pancreatitis prognosis

scoring systems

A

Ranson’s index
APACHE-!!
-BISHAP

28
Q

Ranson’s Criteria

sx present on admission

A

-age >55
-WBC >16000/ul
-blood glucose >200
-serum LDH >350
SGOT (AST) >250

29
Q

developing during first 48 hr

A
  • HCt fall >10%
  • BUN increase >8mg/dl
  • serum Ca less than 8 mg/dl
  • arterial O2 sat <60 mmHg
  • base deficit
  • fluid sequestration
30
Q

BISHAP

A 
BUN >25 mg/dl
- impaired mental status (disorientation etc)
-SIRS
> 60 y/o
pleural effusions
31
Q

early (<1 week) causes of acute pancreatitis

A

SIRS

multiorgan failure

32
Q

late (>1 week) causes of acute pancreatitis

A

multiorgan failute

pancreatic infections/sepsis

33
Q

Cullen’s sign

A

periumbilical hemorrhage

seen in acute pancreatitis

34
Q

Grey Turner’s sign

A

flank hemorrhage

seen in acute pancreatitis

35
Q

late complications of acute pancreatitis

A

pancreatic necrosis

abscess

pancreatic pseudocyst

36
Q

pseudocysts

A

NO epithelial lining

suspect if serum amylase does not return to normal or with persistent pain

may occur after acute pancreatitis (“late” problem)

complications: pain, hemorrhage, infection, peritonitis

37
Q

acute pancreatitis tx

A

-aggressive fluid/electrolyte replacement
-monitoring
analgesia, antiemetics

  • gastric acid suppression, abx, NG tube, nutrition, urgent ERCP if biliary stone obstruction
  • surgical debridement
38
Q

chronic pancreatitis

A
  • fibrosis and destruction of exocrine and endocrine cells
  • irregular pancreatic ducts, narrowed and/or dilated in segments
  • Ca stones
39
Q

chronic pancreatitis pathogenesis

A

-ductal obstruction

  • not after 1-2 attacks of acute pancreatitis
  • injuries may be silent
  • toxic-metabolic
  • necrosis-fibrosis
  • genetic mutations (CFTR, SPINK1)
40
Q

increased pancreatic secretion with increased protein and proteinaceous plugs

A

alcohol induced chronic pancreatitis

41
Q

increased pancreatic secretion and proteinaceous plugs

A

alcohol induced chronic pancreatitis

42
Q

hereditary chronic pancreatitis

A

calcification of pancreatic ducts similar to EtOH path

43
Q

cystic fibrosis –> chronic pancreatitis path

A

similar to alcohol w/ proteinaceous plugs and atrophy

44
Q

chronic pancreatitis pathology

A
  • gradual progressive destruction
  • gross: firm, calcified
  • irregular fibrosis
  • dec size and # of acini
  • chronic inflammation
  • sparing of islets
  • duct destruction
  • pseudocysts
45
Q

3 key histo features of chronic pancreatitis

A
  1. destruction of normal tissue
  2. fibrosis
  3. inflammatory cells
46
Q

features of chronic pancreatitis

A
  • pain
  • calcification
  • pancreatic insufficiency (malabsorption, diabetes)
47
Q

steatorrhea

A
  • dec concentration of lipase and colipase

- dec duodenal pH (inactivation of pancreatic lipase, precipitation of bile salts)

48
Q

sudan III stain

A

steatorrhea

49
Q

dx of chronic pancreatitis

A

Tests of function

  • direct tests (tube tests for enzyme output in pancreatic juice)
  • indirect tests (serum trypsinogen, stool elastase, stool fat, fat sol vit)

-imaging (CT, ERCP, US, XR)

50
Q

chronic pancreatitis tx

A
  • stop alcohol and smoking
  • chronic pain control
  • malabsorption (pancreatic enz, low fat diet)
  • diabetes control
51
Q

tx for neuropathic pain in chronic pancreatitis

A

nerve block
neurolysis
thoracoscopic splanchicectomy

transient relief

52
Q

chronic pancreatitis etiology

A

90% alcohol
10% idiopathic
CF

53
Q

acute pancreatitis etiology

A

50% alcohol
25% gallstones
20% idiopathic

Emma GI (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions