GI & Pancreas

Question 1

What does the exocrine pancreas secrete?

Answer 1

Digestive enzymes
Bicarb-rich secretion
Intrinsic factor
Antibacterial proteins

Question 2

Two common exocrine pancreas disorders

Answer 2

Pancreatitis

Exocrine pancreatic insufficiency (chronic dysfunction)

Question 3

What prevents autodigestion?

Answer 3

Tripsin is only activated by duodenal enteropeptidase

Tripsin activates zymogens (digestive enzymes)

Question 4

Triaditis

Answer 4

Cats
Inflammatory process that involves liver, pancreas, small intestine
Usually ascending, pancreatic duct joins bile duct

Question 5

Pancreatitis CBC abnormalities

Answer 5

Netrophilia w/ left shift
Lymphopenia
Eosinopenia
Thrombocytopenia

Question 6

Pancreatitis Chem abnormalities

Answer 6

Hypercholesterolemia
Increased ALT
Increased ALP
Hyperbilirubinemia
Hypocalcemia
Hyperglycemia

Question 7

Amylase

Answer 7

Produced by pancreatic acinar cells

Cleared by kidneys

Question 8

When is amylase increased?

Answer 8

Pancreatic disease
Renal failure
Severe dehydration

Question 9

Lipase

Answer 9

Produced by pancreatic acinar cells (and other cells)
Cleared by kidneys
Not a good test –> use Spec cPL and Spec fPL

Question 10

Exocrine pancreatic insufficiency (EPI)

Answer 10

Insufficient synthesis and secretion of enzymes

Maldigestion (weight loss, etc)

Question 11

Maldigestion vs malabsorption

Answer 11

Maldigestion: EPI
Malabsorption: GI issue

Question 12

Because EPI is nonimflammatory, CBC and chem often look _____.

Answer 12

Normal

Question 13

What two proteins are looked at with pancreatitis?

Answer 13

Amylase

Lipase

Question 14

What protein is looked at with EPI?

Answer 14

Trypsins

Question 15

Causes of hypocholesterolemia

Answer 15

Decreased hepatic synthesis (disease, shunt)
Decreased intestinal absorption (PLE)
Maldigestion (EPI)

Question 16

What is a likely non-pathologic cause of hypogylcemia?

Answer 16

Changes in blood tube after collection

Question 17

What are pathologic causes of hypoglycemia?

Answer 17

Increased insulin
Decreased insulin antagonists
Decreased gluconeogenesis
Increased glucoe utilization
Pharmacologic
Uncertain pathogenesis

Question 18

Causes of hyperglycemia

Answer 18

Post-prandial
Catecholamine induced
Steroid associated
Endocrine
Drugs
Other

Question 19

What test is specific for PLE?

Answer 19

Fecal Alpha1-Proteinase Inhibitor

Question 20

Small Intestinal Bacterial Overgrowth (SIBO)

Answer 20

Increased abnormal bacterial populations
Secondary to EPI or other causes
Responds to antibiotics (ARE)

Question 21

What is increased with SIBO/ARE?

Answer 21

Folate/Vit B9

“fart folate”

Question 22

What is decreased with SIBO/ARE?

Answer 22

Cobalamin/Vit B12

“consume cobalamin”