Pancreas Flashcards
1
Q
- Alpha Cells (α): Stimulate the release of ______ and ______ stores & Promote ______
- Beta Cells (β): stimulate the release of ______ and Lower the ______ level
- Delta Cells (δ): inhibit ______ and ______ secretion
A
glucagon glycogen gluconeogenesis insulin blood glucose glucagon insulin
2
Q
- Inflammation and hemorrhage of the pancreas due to auto digestion of ______ by ______.
- premature activation of ______ leads to activation of other pancreatic enzymes
- results in ______ hemorrhagic
- most commonly due to ______ and ______; other causes include trauma
- ______ pain that radiates to the ______
- ______ and ______. elevated serum ______ and ______; lipase is more specific for pancreatic damage
- Hypocalcemia (calcium is consumed during ______ in ______)
- complications
- ______—formed by fibrous tissue surrounding liquefactive necrosis and pancreatic enzymes.
- ______- often due to E coli
A
acute pancreatitis pancreatic parenchyma pancreatic enzymes trypsin liquefactive alcohol gallstones epigastric abdominal back nausea vomiting lipase amylase saponification fat necrosis Pancreatic pseudocyst pancreatic abscess
3
Q
- Fibrosis of pancreatic parenchyma, most often secondary to recurrent acute pancreatitis.
- Causes include ______ (adults) and ______ (children), some are idiopathic.
- Clinical features: ______ pain radiating to the ______, Pancreatic insufficiency— results in ______ with ______ and fat- soluble vitamin deficiencies. Dystrophic calcification on X-ray and contrast studies reveal a ______ due to ______ of pancreatic ducts.
- increased risk for ______
A
chronic pancreatitis alcohol cystic fibrosis Epigastric abdominal back malabsorption steatorrhea 'chain of lakes pattern’ dilatation pancreatic carcinoma
4
Q
- Adenocarcinoma arising from the pancreatic ducts
- Most commonly seen in the ______ (average age is ___ years). Major risk factors are ______ and ______.
- Clinical Symptoms: Epigastric abdominal pain and ______, Obstructive ______ with ______ stools and ______; associated with tumors that arise in the ______ of the pancreas (most common location), tumors associated in the body or tail cause secondary diabetes mellitus, ______ (gallbladder distention)
- diagnosis: serum tumor marker is ______
- treatment: includes surgical resection involves of removal of the ______ and ______ of pancreas, proximal duodenum, and gallbladder (______)
- very ______ prognosis and 1-year survival is < __%
- ______: Zollinger-Ellison syndrome with multiple ______ unresponsive to medical therapy; may be part of MEN1 (multiple endocrine neoplasia)
A
adenocarcinoma of the pancreas elderly 70 smoking chronic pancreatitis weight loss jaundice pale palpable gallbladder head Courvoisier’s sign CA 199 head neck Whipple procedure poor 10% Gastrinoma ulcers
5
Q
- Insulin deficiency leading to a metabolic disorder characterized by ______. Due to autoimmune destruction of ______ cells by ______. Characterized by inflammation of ______, linked with HLA-______ and HLA-______, auto-antibodies against insulin are often present and may be seen years before clinical disease develops.
- Symptoms of untreated Type I DM include (3Ps + glucosuria) ______, ______, ______, weight loss, and weakness.
- untreated patients may progress to ______ and ______
- weight loss and low muscle mass will induce ______, ______, and ______ via glucagon which can induce hyperglycemia
- ______, ______, and ______ exceeds renal ability to resorb glucose resulting in excess filtered glucose leading to ______.
- treatment: ______
A
diabetes mellitus: type I (IDDM) hyperglycemia beta T lymphocytes islets DR3 DR4 polydipsia, polyuria, polyphagia ketosis diabetic ketoacidosis gluconeogenesis, glycogenolysis and lipolysis Polyuria, polydipsia, and hyperglycemia osmotic diuresis lifelong insulin
6
Q
- End-organ insulin resistance leading to a metabolic disorder characterized by hyperglycemia. Mostly in middle-aged, obese adults. Obesity leads to decreased numbers of ______
- Insulin levels are ______ early in disease but insulin deficiency develops due to ______ cell exhaustion and evidence of ______ deposition in the ______ in latter stages.
- Clinical features include ______, ______, and ______ (same as IDDM).
- Hyperglycemic hyperosmolar non-ketotic acidosis
- Diagnosis is made by measuring ______ (normal is 70-120 mg/dL).
- Diagnosis: Random glucose > ___ mg/dL, Fasting glucose > ___ mg/dL (two times)
- ______ with a serum glucose level > 200 mg/dL two hours after glucose loading
- Managed with ______ and ______ to stimulate insulin production and increase receptor effectiveness.
A
diabetes mellitus type II (NIDDM) insulin receptors increased beta amyloid islets polyuria, polydipsia, and hyperglycemia glucose levels 200 126 glucose tolerance test dietary changes oral drugs
7
Q
diabetic emergencies for type-1
- ______ (Pathogenesis): Results from the body’s change to fat metabolism and Continuous buildup of ketones produces significant acidosis.
- Signs and symptoms: results in ______ (> 300 mg/dL), ______ metabolic acidosis, and ______
- presents with ______, dehydration, nausea, vomiting, ______ changes, and ______ smelling breath (due to acetone)
- treatment: ______ (corrects dehydration from polyuria), ______, and replacement of ______ (potassium)
A
Diabetic Ketoacidosis hyperglycemia anion gap hyperkalemia kussmaul respirations mental status fruity fluids insulin electrolytes
8
Q
diabetic emergencies for type-2
- ______: Pathogenesis– Found in Type II diabetics, High glucose (> 500 mg/dL) leads to life- threatening diuresis with hypotension and coma.
- ______ are absent due to small amounts of circulating ______
- sustained hyperglycemia results in marked ______
- treatment: ______ (Corrects dehydration from polyuria) and ______
A
Hyperglycemic Hyperosmolar Non-ketotic Coma (HHNC) ketones insulin dehydration fluids insulin
9
Q
Hypoglycemia: ______
-true hypoglycemia defines as blood sugar < ___ mg/dL
-True medical emergency resulting from ______ levels.
-By the time signs and symptoms develop, most of the body’s stores have been used.
-Diabetics with ______ are predisposed to hypoglycemia.
-treatment:
-______ glucose:
-ONLY if intact ______, awake & able to sit up
-___gm-___gm of packaged glucose, or
-May use sugar-containing drink or food
-oral route often ______
-______ glucose:
-Adult: ______ __% (D50) 25gms IV in patent, free-
flowing vein, may repeat
-Children: ______ __% (D25) @ 2 - 4 cc/kg (0.5 - 1 gm/kg)
-Infants: may choose ______ __% @ 0.5 - 1 gm/kg or 5 - 10 cc/kg]
A
insulin shock 60 low blood glucose kidney failure oral gag reflex 15-30 slower intravenous Dextrose 50 Dextrose 25 Dextrose 10
10
Q
complications of diabetes mellitus cardiovascular: -\_\_\_\_\_\_ of extremities -\_\_\_\_\_\_ (damage to the arteries) kidney: -\_\_\_\_\_\_ -damage eye: -retinopathy -\_\_\_\_\_\_ nervous system: -\_\_\_\_\_\_ disease -peripheral \_\_\_\_\_\_
A
gangrene arteriosclerosis infection cataracts cerebrovascular neuropathy
