Module 8: Diseases of the Biliary Tract and Exocrine Pancreas Flashcards
Cholelithiasis AKA
gallstones
Gallstones are associated with obesity, rapid wt loss, type 2 diabetes, and even __________, or sometimes they’re just idiopathic.
pregnancy
Biliary Dyskinesia is a spasm of Sphincter of Oddi that prevents ______ release.
bile
Cholecystitis is the total obstruction of ________ with gall bladder inflammation or blockage by _______________.
bile, gallstones
Cholestasis is sludge build-up in the _______ _____________.
gall bladder
Gallstones are made from what?
cholesterol + bilirubin + calcium salts
Choledocholithiasis is bile duct obstruction by a ___________ that causes abdominal pain and cramping.
stone
T/F: Choledocholithiasis may cause fat malabsorption due to no emulsifying fat and steatorrhea.
T
The main pigment in bile is _______, which gives feces the dark color.
bilirubin
T/F: Backup of bile from choledocholithiasis could lead to jaundice and liver damage.
T
MNT for acute cholecystitis may need NPO and a diet in ________ or MCT to stop gallbladder contractions.
low-fat
Cholecystectomy is the surgical removal of the ___________.
gallbladder
T/F: It’s okay to have excessive amounts of fat after having a cholecystectomy.
F
T/F: You DON’T NEED to have a gallbladder.
T
The pancreas is a ___________ organ.
glandular
The pancreas has endocrine and ________ glands.
exocrine
The endocrine glands in the pancreas are ductless and secrete hormones into the ___________.
bloodstream
The exocrine glands in the pancreas secretes ________ enzymes and ________ rich fluid through _______ (i.e. intestinal lumen) that lead to the primary pancreatic duct.
digestive, bicarbonate, ducts
Cephalic stimulation is mediated by the ________ nerve that signals the pancreas to release digestive juices.
vagus
Through cephalic stimulation, sight, smell, taste or the thought of ______ can trigger the secretion of __________ and pancreatic enzymes.
food, bicarbonate
Gastric distention (food in the stomach) can stimulate _________ secretion from the pancreas.
enzyme
The major stimulus for pancreatic secretion is when _______ reaches the _______.
food, duodenum
When food reaches the duodenum, the SI release _____ and __________ which travel through the blood to the pancreas.
CCK, secretin
Secretin stimulates the release of __________ rich fluid to neutralize the acidic chyme.
bicarbonate
CCK stimulates the release of _________ enzymes.
pancreatic
Pancreatitis is inflammation of the _________.
pancreas
T/F: Pancreatitis can lead to premature activation of _______ enzymes in the pancreas instead of the duodenum.
zymogen
Pancreatic proteases are secreted as _________ into the SI.
zymogens
T/F: Pancreatitis can cause severe abdominal pain.
T
You can see elevated levels of pancreatic enzymes (of CHO and fat digestion) of serum ________ and ________in someone with pancreatitis.
amylase, lipase
T/F: About 25% of acute pancreatitis will go on to chronic pancreatitis
T
T/F: Low levels of triglycerides can lead to pancreatitis.
F (high levels)
T/F: Excessive alcohol intake can lead to pancreatitis.
T
T/F: Gallstones can lead to pancreatitis.
T
MNT for acute pancreatitis may be _____ on IV fluids for a couple of days and _______ feeding (parenteral nutrition) may be issued within a few days.
NPO, tube
Those with pancreatitis may need _____PRO needs in their diet.
higher
T/F: It is important to NOT OVERFEED patients with pancreatitis.
T
T/F: Those with pancreatitis may have low blood glucose.
F (high blood glucose)
T/F: Somatostatin can be added in MNT for pancreatitis to inhibit pancreatic secretion.
T
__________ nutrition is always preferable to parenteral nutrition for MNT of pancreatitis.
Enteral
For severe cases of pancreatitis, MNT may be using _______ tube feedings to bypass the gastric phase of pancreatic secretion.
jejunal
______ is the most potent stimulus for the release of pancreatic enzymes.
CCK
______ is the most potent stimulus for CCK release.
Fat
Chronic pancreatitis is usually presented as current flare-ups of ________ ____________.
acute pancreatitis
T/F: Chronic pancreatitis could be idopathic.
T
Chronic pancreatitis could lead to secondary _________ because it could lead to damage of the _______ cells that secrete insulin.
diabetes, beta
The most common cause chronic pancreatitis is what?
Heavy alcohol consumption
MNT for chronic pancreatitis includes ________ diet, small & frequent meals, supplemental pancreatic enzymes taken before meals, ______-chain triglycerides, antacids, H2 blockers or PPIs to reduce stomach acid,
low-fat, medium
Vitamin deficiencies in B12, A, D, E, and K must be monitored in patients with ______ pancreatitis.
chronic
