Pancreas Flashcards
What is the exocrine portion of the pancreas do?
Produces enzymes to help break down fats, proteins and carbs
What type of cells are found in the exocrine pancreas?
Ancinar cells
What 3 enzymes does the pancreas produce? What do they digest?
1)Amylase-Carbs into sugars
2)Lipase-fats into fatty acids and gylcerol
3)Trypsin- protein into amino acids
What are the ancinar cells responsible for?
produce digestive enzymes and release them in an INACTIVE form to prevent self digestion of the pancreas
How does the ductal system work?
-Ducts transport enzymes and. bicarb to duodenum
-bicarb neutralizes the stomach acid to create optimal pH for digestive enzymes
What is pancreatitis
Inflammation due to enzyme activation within the organ itself
What are the leading causes of acute pancreatitis for males and females?
Males- ETOH
Females- Gallstones
Pathophysiology of acute pancreatitis
Acinar cells injured –> zymogens(inactive enzymes) are prematurely activated–>Typsin auto digests–> inflammatory cascade–> leads to SIRS
What are the lab values in acute pancreatitis?
Enzymes =3x upper normal
Leucocytosis
Hypocalcemia
⬆️ liver enzymes if gallstones are the cause
⬆️ CRP
Risk factors for acute pancreatitis
ETOH
Gallstones (most common)
Infection(mumps, coxsackie)
Meds (valproate, azithioprine)
Trauma
What two signs might you see with acute pancreatitis
Cullins sign(periumbillical bruising) and Grey Turner sign(flank bruising)
What lab values are elevated in chronic pancreatitis
Amylase/Lipase
CRP and ESR
ALP, GTT, Bilirubin (if obstruction related)
Calcium
Triglycerides
What is the most common cause of chronic pancreatis
Alcohol abuse
Pathophysiology of chronic pancreatitis
Injured Aciner cells release Damps–> activate innate immune system–>inflammatory mediators resleased–> stellate cells activated by cytokines–>produce extracellular matrix that leads to fibrosis
What does the persistent fibrosis in chronic pancreatitis cause
Tissue remodeling: further loss of acinar cells; damages the islet cells of the endocrine pancreas
What is the positive feedback loop of chronic pancreatitis?
DRIVES PROGRESSION OF CHRONIC DISEASE
Enzyme activation–> inflammation–> fibrosis–> duct obstruction–> more enzyme activation
What is steatorrhea
Stool that has heavy fat content
Floats and has a foul smell
Risk factors for chronic pancreatis
Alcoholism
Autoimmune
Duct obstruction
Idiopathic
Recurrent acute pancreatitis
Risk factors for pancreatic cancer
Smoking
High fat diet
Obesity
Alcoholism
Genetics
DM
Chronic pancreatitis
What is the primary mutation found in pancreatic cancer
KRAS pathway =90% of cases; promote uncontrolled cell growth
