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Clinical Pathology Exam 4 > Lecture 2 > Flashcards

Lecture 2 Flashcards

1
Q

What cells are in the exocrine pancreas? What do they release?

A

Acinar cells- digestive enzymes

Ductular cells- electrolytes, intrinsic factor, antibacterial proteins

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2
Q

What does the exocrine pancreas do?p

A

Source of digestive enzymes, bicarb rich secretions to neutralize gastric secretions, source of intrinsic factor for cobalamin absorption, secretes antibacterial proteins

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3
Q

What are two common exocrine pancreas disorders?

A

Pancreatitis, exocrine pancreatic insufficiency

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4
Q

What prevents autodigestion?

A

The enzymes are made as zymogens that have to be activated in the duodenum by trypsin

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5
Q

What is triaditis

A

Inflammation of liver, pancreas, and small intestine in cats

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6
Q

What possible CBC abnormalities will you see with pancreatitis?

A

Neutrophilia with left shift and toxicity
Lymphopenia
Thrombocytopenia

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7
Q

What possible chem abnormalities will you see with pancreatitis?

A

High cholesterol, ALT, ALP, bilirubin, and glucose

Low calcium

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8
Q

What pancreatic enzymes can we measure?

A

Trypsins
Alpha amylase
Lipase

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9
Q

What is amylase produced by?

What is it cleared by?

A

Produced by pancreatic acinar cells, small intestine, and saliva in pigs

Cleared by kidney

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10
Q

What could increased amylase mean?

A

Pancreatic disease, GI disease, Renal failure, other causes of decreased GFR (pre or post renal)

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11
Q

What does decreased amylase mean?

A

Nothing

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12
Q

What is lipase produced by?

What is it cleared by?

A

Pancreatic acinar cells, gastric mucosal cells, small intestine, liver, adipocytes, myocytes

Cleared by kidney

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13
Q

If lipase is increased more than 3 fold, what is it likely due to?

A

Pancreatic disease

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14
Q

When would lipase be decreased?

A

EPI

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15
Q

What is PLI?

A

Measure of specific pancreatic lipase

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16
Q

What is EPI?

A

Exocrine pancreatic insufficiency- insufficient synthesis and secretion of digestive enzymes

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17
Q

What can cause EPI (maldigestion)

A 
Congenital abnormality
Chronic pancreatitis
Pancreatic duct obstruction
Ischemia
Immune mediated disease
Toxic damage
Infection
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18
Q

What can be associated problems with EPI?

A

Concurrent diabetes mellitus
Secondary small intestine bacterial overgrowth
Secondary cobalamin deficiency

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19
Q

What will you see on CBC/chem with EPI?

A

Mostly normal

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20
Q

When will trypsin increase?

Decrease?

A

Pancreatitis, pancreatic hypertrophy, renal disease, small intestinal disease

EPI

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21
Q

What test is best for diagnosing EPI?

A

Trypsin

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22
Q

What can cause GI disease (malabsoprtion)?

A

Inflammation/cancer thickening the GI tract

Parasitism or other infection

Lymphatic disease

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23
Q

What are major causes of chronic intestinal disease in small animals?

A 
IBD
Triaditis in cats
GI lymphoma
Lymphangiectasia (dogs only)
Pythiosis (dogs only)
GI histoplasmosis
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24
Q

What are malabsorptive diseases in equids?

A

Lymphoma
IBD
Infectious

25
Q

What are malabsorptive diseases in bovine?

A 
Calf diarrhea
Johnes disease (mycobacterium)
26
Q

What are causes of hypocholesterolemia?

A

Decreased hepatic synthesis (liver disease, PSS)

Decreased intestinal absorption (PLE)

Maldigestion (EPI)

Hypoadrenocorticism

27
Q

What does insulin do to glucose?

A

Causes glucose to go into cells and decrease serum glucose

28
Q

What does glucagon, catecholamines, growth hormone, and corticosteroids do to glucose?

A

Antagonize insulin and cause glucose to not be taken up into cells and increase serum glucose

29
Q

What might cause a artifactual decreased glucose?

A

Not separating the serum from cells within 30 minutes (because the cells will continue using glucose)

30
Q

What are some clinical signs of hypoglycemia?

A 
Lethargy
Incoordination
Exercise intolerance
Seizures
Coma
31
Q

What would cause hypoglycemia (increased insulin secretion)

A

Insulinoma

Xylitol toxicity

32
Q

What would cause hypoglycemia

Decreased insulin antagonists

A

Hypocortisolemia

33
Q

What would cause hypoglycemia

Decreased gluconeogenesis

A

Liver insufficiency/failure
Hypocortisolemia
Neonatal hypoglycemia
Starvation/ severe malnutrition

34
Q

What would cause hypoglycemia

Increased glucose utilization

A

Lactation

Exertion

35
Q

What would cause hypoglycemia

Uncertain pathogenesis

A

Sepsis

Neoplasms

36
Q

What would cause hypoglycemia

Pharmacologic

A

Insulin

Sulfonylurea compounds

37
Q

What would cause hyperglycemia?

A 
Post prandial
Catecholamine induced (fractious animal)
Steroid induced
Diabetes, Cushings, acromegaly, hyperpituitarism (PPID)
Dextrose, xylazine, ketamine
Glucogonoma
Pancreatitis
Early sepsis
Proximal duodenal obstruction in cattle
Sick neonatal llamas and alpacas
38
Q

When would a fecal test for malabsorption be helpful?

A

When PLE is suspected

39
Q

What is SIBO?

A

ARE

Overgrowth of bacteria in intestine

40
Q

What causes SIBO?

A

EPI
Other intestinal disorders
Idiopathic

41
Q

When would folate/B9 be increased?

What produces it?

A

ARE/ SIBO

Bacteria

42
Q

When would cobalamin (B12) be decreased?

A

ARE/SIBO

43
Q

Describe serum values fro EPI

A

Folate- normal or increased
Cobalamin- decreased
TLI- decreased

44
Q

Describe serum values for SIBO

A

Folate- increased
Cobalamin- decreased
TLI- normal

45
Q

Describe serum values for proximal small intestinal disease

A

Folate- decreased
Cobalamin- normal
TLI- normal

46
Q

Describe serum values for distal small intestinal disease

A

Folate- normal
Cobalamin- decreased
TLI- normal

47
Q

Describe serum values for diffuse small intestinal disease

A

Folate- decreased
Cobalamin- decreased
TLI- normal

48
Q

When might BUN:creat be high (GI)

A

Pre renal azotemia or GI hemorrhage

49
Q

When would TP be low (GI)

A

PLE

50
Q

When would albumin be low (GI)

A

PLE

51
Q

When would globulins be low (GI)

A

PLE

52
Q

When would cholesterol be low (GI)

A

PLE

53
Q

When would calcium be low (GI)

A

Intestinal malabsorption or secondary to hypoalbuminemia

54
Q

When would magnesium be low (GI)

A

Low with decreased intake (anorexia), decreased GI absorption

55
Q

When would phosphorus be low (GI)

A

Decreased intake (anorexia) or decreased GI absorption

56
Q

When would sodium be low (GI)

When would sodium be high (GI)

A

High if pure water is lost through GI tract

Low if isotonic or sodium rich fluid is lost through GI tract

57
Q

When would potassium be low (GI)

A

If lost in GI tract +/- anorexia

58
Q

When would chloride be high (GI)

Low? (GI)

A

High if pure water is lost by GI tract
Low if isotonic fluid or chloride rich fluid is lost through GI
Disproportionally elevated relative to sodium if bicarb is being lost

59
Q

When would bicarb be high (GI)

Low?

A

High with upper GI disease and selective loss of HCl

Low if losing bicarb in diarrhea

Clinical Pathology Exam 4 (4 decks)

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