Pacreatic enzymes

Question 1

What is the normal ri for adult amylase?

Answer 1

60-120 Somogyi units/dl (SI/dl)

Question 2

What is the critical value for amylase?

Answer 2

> 360 SI/dl

Question 3

When are amylase levels slightly increased?

Answer 3

Pregnancy

Elderly

Question 4

What are the indications for amylase testing?

Answer 4

1. Detect and monitor course of pancreatitis

2. Frequently ordered when a patient presents with acute abd pain

Question 5

What is the function of amylase?

Answer 5

Aids in catabolism carbs

Question 6

What test is frequently ordered with amylase?

Answer 6

Lipase

Question 7

Where is amylase produced?

Answer 7

Amylase secreted from acinar cells  pancreatic duct  duodenum

Question 8

What can increased amylase levels result from?

Answer 8

1. Damage to acinar cells
A. Pancreatitis
2. Obstruction pancreatic duct flow 
A. Pancreatic Ca 
B. CBD stone

Question 9

How soon do amylase levels increase in response to acute pancreatitis?

Answer 9

12 hrs

Question 10

When do amylase levels resolve after acute pancreatitis?

Answer 10

Level returns to normal within 48-72 hours after onset of symptoms

Question 11

Whta disease causes persistently elevated amylase levels?

Answer 11

Pancreatic duct obstruction

Question 12

How is amylase cleared from the body?

Answer 12

kidneys

Question 13

How does amylase enter the blood stream?

Answer 13

Enzyme flows into pancreatic lymph system and peritoneum, then into blood

Question 14

What is amylase specific for?

Answer 14

1. Pancreatitis
2. Bowel perforation
3. Penetrating peptic ulcer
4. Duodenal obstruction
5. Mumps
6. Renal failure: cannot clear amylase
7. DKA: increases sugar levels inflame liver

Question 15

What is the most sensitive test for pancreatitis?

Answer 15

Amylase

Question 16

What conditions are asst. with decreased amylase levels?

Answer 16

1. Chronic pancreatitis
   A. Pancreatic cell destruction, very few pancreatic cells left to make amylase
   B. Massive hemorrhagic pancreatic necrosis

Question 17

What are the normal RI for lipase in adults and children?

Answer 17

0-160 SI units/l

Question 18

What are the indications for lipase testing?

Answer 18

Evaluation of pancreatic disease

Question 19

What is the function of lipase?

Answer 19

Breaks down triglycerides into fatty acids

Question 20

Where is lipase secreted?

Answer 20

Lipase secreted by pancreas into duodenum

Question 21

What are increased lipase levels asst. with?

Answer 21

Damage to or disease affecting pancreatic acinar cells

Question 22

How soon after acute pancreatitis do lipase levels rise? How long do they remain elevated for?

Answer 22

24-48 hours after onset of symptoms,

remain elevated for 5-7 days

Question 23

How high are lipase levels in acute pancreatitis?

Answer 23

Lipase elevations are 5-10x normal values

Question 24

What is the lipase test most useful for diagnosing?

Answer 24

Because they peak later and last longer than serum amylase levels, serum lipase levels are more useful in late diagnosis of acute pancreatitis. Less useful in diagnosing chronic pancreatitis

Question 25

What conditions are asst. with lipase?

Answer 25

1. Pancreatic diseases: lipase exits panc cells and is released into bloodstream
   A. Acute pancreatitis
   B. Pancreatic cancer
   C. Pancreatic pseudocysts
2. Renal failure
3. Salivary gland 4. inflammation
4. Biliary disease: lipase exists inside cells of hepatobiliary system
   A. Acute cholecystitis
   B. Extrahepatic duct obstruction
5. Intestinal disease: lipase exists in lining duodenum
   A. Bowel obstruction
   B. Bowel infarction
6. Peptic ulcer disease: lipase in GI tract leaks out into peritoneum