Lecture 1 1/23/25 Flashcards

1
Q

How do the bile and pancreatic ducts differ between dogs and cats?

A

-dogs have separate bile and pancreatic ducts
-cats have a fused beginning of the bile and pancreatic duct

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2
Q

Which cell types are found within the pancreas?

A

-alpha cell
-beta cell
-delta cell
-exocrine pancreas (acinar and duct cells)
-F cell

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3
Q

What is the role of alpha cells?

A

secrete glucagon

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4
Q

What is the role of beta cells?

A

secrete insulin

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5
Q

What is the role of delta cells?

A

secrete somatostatin

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6
Q

What is the role of F cells?

A

secrete pancreatic polypeptide

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7
Q

What is trypsinogen?

A

inactive form of trypsin

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8
Q

What is the role of trypsin?

A

involved in the conversion and activation of all other exocrine pancreas enzymes

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9
Q

How can trypsinogen be converted into trypsin?

A

-enterokinase, which is physiologically released following ingestion
-pathologic stimuli including cathepsin B and ischemia

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10
Q

Why is trypsinogen important?

A

having an inactive form of trypsin prevents the pancreatic enzymes from being continuously produced and digesting the pancreas itself

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11
Q

What is the role of pancreatic secretory trypsin inhibitor?

A

to inhibit active trypsin and prevent pancreatic digestion by enzymes

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12
Q

Why is it important that the duct cells secrete NaHCO3?

A

this solution buffers pH and prevents an environment that would promote trypsinogen activation

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13
Q

Why is it important that there is a unidirectional flow of enzymes through and out of the pancreas?

A

prevents enzymes from remaining in the pancreas once activated and causing damage

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14
Q

What is the importance of an apical block?

A

it prevents the release of activated trypsin from the pancreatic cells, which leads to enzymes digesting the pancreas

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15
Q

What happens when pancreatic enzymes are released within the cells inappropriately?

A

the pancreatic fat becomes inflamed

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16
Q

What are the general characteristics of acute pancreatitis in dogs?

A

-inflammation of the pancreas
-sudden onset
-activation of enzymes within the gland leads to autodigestion
-tissue injury occurs

17
Q

What is the “balancing act” that occurs within the pancreas?

A

-supportive care and treatment helps promote the protective mechanisms of the pancreas and allow for absence of disease
-genetic and/or environmental risk factors can increase stressors and result in pancreatic injury

18
Q

What are the histological findings in acute pancreatitis?

A

-neutrophilic inflammation
-edema
-necrosis

19
Q

What are the histological findings in chronic pancreatitis?

A

-fibrosis
-acinar loss

20
Q

How do dogs and cats differ in terms of pancreatitis?

A

dogs are more likely to get acute pancreatitis while cats more commonly get chronic pancreatitis

21
Q

What are the clinical signs of pancreatitis in dogs?

A

-vomiting
-abdominal pain
-depression
-anorexia
-fever
-shock and collapse
-coagulopathy/DIC

22
Q

What are the clinical signs of pancreatitis in cats?

A

-anorexia and lethargy
-potential vomiting
-potential pain
-triaditis/inflammation of liver, pancreas, and small intestine

23
Q

What are the predisposing factors for pancreatitis?

A

-dietary factors
-ischemia/reperfusion
-hyperlipidemia
-drugs/toxins
-breed predilection/schnauzers and terriers
-duct obstruction
-duodenal/biliary reflux
-trauma
-cryptogenic/unknown

24
Q

What are the signs of pancreatitis on clin path?

A

-left shift neutrophilia
-hyperlipidemia
-increased amylase and/or lipase
-concurrent increase of liver enzymes
-hyper- or hypoglycemia
-hypocalcemia
-azotemia

25
What are the characteristics of canine pancreatic lipase immunoreactivity?
-quantitative assessment via Spec -qualitative assessment via SNAP -SNAP test is good for ruling out pancreatitis at GP level -SNAP test assessment is either normal, grey zone, or abnormal
26
What are the characteristics of lipase DGGR?
-90% correlation to cPLI -negative result excludes pancreatitis
27
What are factors that could increase cPLI and DGGR, and potentially cause a false positive pancreatitis?
-renal disease -cardiac disease -diabetes -hyperadrenocorticism -any upper GIT inflammation
28
Which tests are used for pancreatitis diagnosis in felines?
-feline pancreatic lipase immunoreactivity/fPLI -lipase DGGR
29
What findings on radiographs can indicate pancreatitis?
-left-displaced pylorus -right-displaced, enlarged duodenum -visualization of pancreas as soft tissue opacity -duodenal ileus -peritonitis
30
Which imaging modality is the optimal choice for pancreatitis diagnosis?
ultrasound
31
Which findings on ultrasound can indicate pancreatitis?
-corrugated duodenum -enlarged hypoechoic pancreas -hyperechoic fat
32
What are the characteristics of hypovolemia associated with pancreatitis?
-associated with excessive vomiting and diarrhea -can lead to peritonitis -can cause pain -can lead to acute kidney injury
33
What are the hepatobiliary consequences of pancreatitis?
-impaired liver function -obstruction of the biliary duct/biliary statis (typically functional)
34
What are the respiratory consequences of pancreatitis?
-ALI or ARDS in up to 45% of severe panc. cases -aspiration pneumonia from vomiting -pleural effusion
35
What is the pathophysiology of DIC related to pancreatitis?
-digestive enzymes and inflammatory cytokines enter circulation -enzymes and cytokines cause vasodilation -vasodilation results in hypotension, pulmonary edema, and DIC
36
What are the three main considerations of pancreatitis treatment?
-never let them vomit -never let them suffer -never let them starve