pancreas

Question 1

why are pancreatic proteases secreted in an inactive form

Answer 1

to protect from auto-digestion

Question 2

how much reduction in lipase before fat malabsorption occurs

Answer 2

90-98%

Question 3

what are some of things that control pancreas function

Answer 3

1. PNS
2. CCK - stim by fat/acid in duodenum&raquo_space; panc enzymes
3. secretin - stim by fat/acid in duodenum&raquo_space; water/bicarb from pancreas
4. gastrin

Question 4

3 ways to indirectly test the pancreas

Answer 4

1. fat globules/crystals
2. 72h stool collection
3. faecal elastase

Question 5

most common congenital pancreatic abnormality

Answer 5

pancreas divisum - instead of single pancreatic duct, two distinct ducts as failed to fuse

Question 6

what is an annular pancreas

Answer 6

ring of pancreatic tissue surrounding duodenum, can cause obstruction

Question 7

two most commoncauses of pancreatic insufficiency

Answer 7

a. Cystic fibrosis – most common
b. Shwachman-Diamond syndrome - 2nd most common

Question 8

what can be used to measure creon effectiveness and why?

Answer 8

faecal elastase - there’s no elastase in creon!

Question 9

side effects of creon

Answer 9

1. inc uric acid
2. fibrosing colonopathy

Question 10

Schwachman-Diamond Syndrome

Answer 10

SPAM:
short
pancreatic insufficiency/pancytopaenia
aplastic anaemia/AML
metaphyseal lesions /MDS

Question 11

drug-induced pancreatitis

Answer 11

FATSHEEP:
frusemide
aza/asparaginase
thiazides/tetracyclines
statins/sulfonamides
HCT
ethanol
pentamidine

Question 12

two distinct syndromes of chronic pancreatitis

Answer 12

1. autoimmune pancreatitis: type 1 systemic, type 2 isolated to pancreas. a/w elevated igG
2. juvenile tropical pancreatitis: Kerala. 50% SPINK.

Question 13

most common pancreatic neoplasm in children

Answer 13

pancreatoblastoma - high AFP