GI 2C - Anatomy, Physiology and Pathology of the Pancreas Flashcards
Enzymes included in the pancreas juice:
pancreatic amylase, pancreatic lipase, colipase, trypsinogen, chymotripsinogen, procarboxypeptidase (A/B), proelastase, ribonuclease, deoxyribonuclease.
____ is the only potentially curative treatment for exocrine pancreatic cancer but because of the late presentation of the disease, only 15-20% of patients are candidates for pancreatectomy.
Surgical resection
Characteristics of cystic fibrosis include malfunction of ____ resulting in increased viscosity of mucus and increased chloride concentration in sweat and tears.
exocrine glands
How do gallstones cause pancreatitis?
biliary tract obstruction, pancreatic duct obstruction or biliary reflux is believed to activate the enzymes in the pancreatic duct system.
There is some evidence for a _____ reflex secretion of pancreatic juice in response to the sight or smell of food.
vagally-mediated conditioned
____ deficiency can occur as a congenital abnormality, which leads to protein malnutrition.
Enterokinase
Although a number of factors are associated with the development of acute pancreatitis, most cases result from ___ or ____.
gallstones or alcohol abuse.
Releasing trypsin in its active form can lead to a chain reaction of producing several active enzymes capable of digesting the pancreas. Hence, pancreatic tissue normally contains ____.
trypsin inhibitors
____ – production of pancreatic juice. Source of HCO3 to neutralize gastric acid. Source of many digestive enzymes
Exocrine pancreas
____% of patients with pancreatic cancer have a first degree relative with the disease.
5-10%
The most common lethal genetic diseases among whites is ____.
cystic fibrosis
Common symptoms of acute pancreatitis.
- Epigastric and abdominal pain (aggravated when supine) - Abdominal distention - Hypoactive bowel sounds - Loss of a large volume of fluid into the abdominal cavity - Tachycardia - hypotension - cool clammy skin - Fever - Signs of hypocalcemia (result of serum calcium precipitation in fat necrosis) - Mild jaundice (due to biliary obstruction)
____ is a severe, life-threatening disorder associated with the escape of activated pancreatic enzymes into the pancreas and surrounding tissues.
Acute pancreatitis
Compared to tumors in the body and tail of the gland, pancreatic head tumors more often present with ____, ____ and ____.
jaundice, steatorrhea and weight loss
In pancreatitis, enzymes cause ____, or auto digestion, of the pancreas and produce deposits in the abdominal cavity with hemorrhage from the necrotic vessels.
fat necrosis
The commonly used term “pancreatic cancer” usually refers to a _____ of the pancreas.
ductal adenocarcinoma
Clinical manifestations of cystic fibrosis include:
chronic pulmonary disease, pancreatic insufficiency, meconium ileus
Measurement of plasma ____ or pancreatic lipase is of value in diagnosing problems associated with inflammation and necrosis of pancreatic acinar cells.
pancreatic amylase, pancreatic lipase
____ – production of insulin & glucagon; plasma glucose regulation.
Endocrine pancreas
___ acts on the pancreas to cause copious secretion of a very alkaline pancreatic juice that is rich in HCO3 and low in enzymes.
Secretin
Trypsin then converts 3 zymogens to their active forms. What are they?
Chymotripsinogen –> Chymotrypsin Procarboxypeptidase –> Carboxypeptidase Proelastase –> Elastase
Bile, intestinal juices and pancreatic juice are all ___ solutions that help neutralize gastric acid, raising the duodenal contents to a pH of ____.
alkaline, 6.0-7.0
The 5 year survival following pancreaticoduodenectomy is about 25-30% for ____ and 10% for ___ tumors.
node-negative, node-positive
How does alcohol cause pancreatitis?
Precise mechanisms are largely unknown. Alcohol is known to be a potent stimulator of pancreatic secretions. It also causes contraction of the sphincter of iddi to the pancreatic duct.
