Gastric, Intestinal, and Pancreatic Function (PART 2)

Question 1

Compare Chohn’s and ulcerative colitis

Answer 1

Both: form of inflammatory bowel disease, autoimmune etiology, genetic
Chron’s: can affect any portion of intestine; 10-30% test positive for ANCA test
Colitis: disease of large intestine ONLY; 60-80% test positive for ANCA test

Question 2

Cause of celiac disease

Answer 2

hypersensitivity to grains (gluten)

- genetics, immune system, environment

Question 3

symptoms of celiac disease

Answer 3

• ab bloating and pain
• chronic constipation and/or diarrhea
• weight loss
• pale, foul-smelling stool
• Flatulence
  (many more see slide 108)

Question 4

treatment for celiac disease

Answer 4

remove gluten from diet

Question 5

Best screening test for colon cancer

Answer 5

Occult Blood test

Question 6

Carcinoid Syndrome

- symptoms

Answer 6

Tumors produce serotonin which cause the symptoms of hypertension flushing, wheezing, diarrhea, right-sided valvular disease, etc.

Question 7

Carcinoid Syndrome

- lab diagnosis

Answer 7

Screen for 5-HIAA in urine

Question 8

Carcinoid Syndrome

- treatment

Answer 8

Surgical excision of the tumor(s) is the only treatment

Question 9

Endocrine functions of the pancreas

Answer 9

• Beta cells secrete insulin
• Alpha cells secrete Glucagon
• Delta cells secrete Gastrin and Somatostatin

Question 10

Exocrine functions of the pancreas

Answer 10

80% of mass made of acinar cells, grape-like clusters of cells, that produce digestive enzymes

Question 11

Physiological effects of insulin

Answer 11

Uptake of glucose

Question 12

Physiological effects of glucagon

Answer 12

Release of glucose from glycogen

Question 13

Physiological effects of gastrin

Answer 13

HCL production

Question 14

Consequences of secretin and CCK-PZ release on the pancreas

Answer 14

Secretin: made when acidic stomach contents reach duodenum; responsible for bicarb release; inhibits gastrin production in stomach
CCK-PZ: made by intestinal mucosal cells; responsible for enzyme release from pancreatic acinar cells

Question 15

Consequences of Vagus nerve stimulation on the pancreas

Answer 15

Can cause pancreatic fluid secretion during cephalic phase of digestion

Question 16

Five enzymes produced by the pancreas and their substrates

Answer 16

1. Amylase: acts on starch and carbs
2. Lipase: acts on trigs
3. Chymotrypsin: cleave peptide bonds following phenylalanine, tryptophan, and tyrosine residues
4. Trypsin: acts on proteins (catalyzes the hydrolysis of peptide bonds)
5. Elastase -1: acts on elastin

Question 17

Cystic Fibrosis

- cause

Answer 17

Autosomal recessive; most common genetic mutation is Delta F508 on long arm of chromosome 7

Question 18

Cystic Fibrosis

- symptoms

Answer 18

disrupts the function of several organs by clogging tubes

Question 19

Cystic Fibrosis

- clinical course

Answer 19

Meconium ileus at birth (bowel obstruction)

• Chronic respiratory infections
• Malabsorption with failure to thrive
• Median survival: 30 years

Question 20

Cystic Fibrosis

- lab findings

Answer 20

Sweat Chloride Measurement >60 mEq/L on two occasions

Question 21

Cancer of the head of the pancreas

- symptoms and lab findings

Answer 21

• detected earlier than other pancreatic cancer

- Jaundice, weight loss, anorexia, nausea

Question 22

Cancer of the beta cell tumors

- symptoms and lab findings

Answer 22

Cuased very low blood sugars and associated symptoms

Question 23

Cancer of the alpha cell tumors

- symptoms and lab findings

Answer 23

have a very poor prognosis; detected later because of lots of other diseases cause hyperglycemia

Question 24

Acute Pancreatitis:

- common causes

Answer 24

• Cholelithiasis (gallstones)
• Excess alcohol intake
• Trauma, mumps, thrombosis, drugs
• Idiopathic

Question 25

Acute Pancreatitis:

- common symptoms

Answer 25

Acute ab pain radiating to the upper back

Question 26

Acute Pancreatitis:

- length of time that amylase and lipase remain elevated in the serum after an attack

Answer 26

• Rises within 24 hours, returns to normal in 3 or 4 days

- Lipase: Rises about the same time, stays elevated for 2 weeks