PANCREAS ANAPHY and Acute Pancreatitis Flashcards

1
Q

What is the primary endocrine function of the pancreas?
a. Producing insulin
b. Completing starch digestion
c. Neutralizing acidic chyme
d. Breaking down nucleic acids

A

Answer:
a. Producing insulin

Rationale:
The pancreas has both endocrine and exocrine functions. It produces insulin (and glucagon) as part of its endocrine function to regulate blood glucose levels.

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2
Q

The pancreas produces
a) sodium bicarbonate
b) peptidases and proteinases
c) lipases and amylase
d) nucleases
e) all of the above

A

Answer: e) all of the above

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3
Q

Which enzyme is responsible for promoting fat breakdown and absorption?
a. Pancreatic amylase
b. Pancreatic lipase
c. Trypsin/chymotrypsin
d. Nucleases

A

Answer:
b. Pancreatic lipase

Rationale:
Pancreatic lipase is responsible for promoting the breakdown and absorption of fats.

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4
Q

What is the primary role of trypsin/chymotrypsin in pancreatic enzyme function?
a. Completing starch digestion
b. Promoting fat breakdown
c. Breaking down nucleic acids
d. Protein digestion

A

Answer:
d. Protein digestion

Rationale:
Trypsin/chymotrypsin is responsible for half of all protein digestion in the pancreatic enzyme function.

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5
Q

Which clinical manifestation is associated with acute pancreatitis and characterized by pain in the left upper quadrant 3-4 hours after the ingestion of alcohol and fatty acids?
a. Periumbilical ecchymosis (Cullen’s Sign)
b. Hemorrhage
c. Bruising in the stomach
d. Flank ecchymosis (Grey Turner’s Sign)

A

Answer:
a. Periumbilical ecchymosis (Cullen’s Sign)

Rationale:
Pain in the left upper quadrant 3-4 hours after the ingestion of alcohol and fatty acids is associated with acute pancreatitis and is a symptom of periumbilical ecchymosis (Cullen’s Sign).

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6
Q

What is the significance of Grey Turner’s Sign in acute pancreatitis?
a. Indicates severe pancreatitis
b. Suggests gallbladder inflammation
c. Confirms autoimmune pancreatitis
d. Predicts thrombocytopenia

A

Answer:
a. Indicates severe pancreatitis

Rationale:
Grey Turner’s Sign, manifested by flank ecchymosis, indicates severe pancreatitis and possible complications like hemorrhage or necrosis.

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7
Q

What is the primary role of trypsin and chymotrypsin in the pancreas?
a. Initiating fat digestion
b. Breaking down nucleic acids
c. Enhancing protein synthesis
d. Facilitating starch digestion

A

Answer:
c. Enhancing protein synthesis

Rationale:
Trypsin and chymotrypsin are responsible for HALF OF ALL THE PROTEIN DIGESTION, playing a crucial role in enhancing protein synthesi

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8
Q

Which pancreatic enzyme completes starch digestion?
a. Pancreatic amylase
b. Pancreatic lipase
c. Trypsin/chymotrypsin
d. Nucleases

A

Answer:
a. Pancreatic amylase

Rationale:
Pancreatic amylase is responsible for completing starch digestion

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9
Q

What does the sphincter of Oddi being inflamed contribute to in acute pancreatitis?
a. Increased fat absorption
b. Auto-digestion of the pancreas
c. Enhanced protein digestion
d. Accelerated starch digestion

A

Answer:
b. Auto-digestion of the pancreas

Rationale:
Inflamed sphincter of Oddi contributes to the inability to remove pancreatic juices, leading to auto-digestion of the pancreas in acute pancreatitis.

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10
Q

Which enzyme is involved in breaking down nucleic acids?
a. Pancreatic amylase
b. Pancreatic lipase
c. Trypsin/chymotrypsin
d. Nucleases

A

Answer:
d. Nucleases

Rationale:
Nucleases are responsible for breaking down nucleic acids.

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11
Q

What clinical finding suggests the seepage of blood-stained exudates from the pancreas in acute pancreatitis?
a. Hemorrhage
b. Periumbilical ecchymosis (Cullen’s Sign)
c. Bruising in the stomach
d. Flank ecchymosis (Grey Turner’s Sign)

A

Answer:
d. Flank ecchymosis (Grey Turner’s Sign)

Rationale:
Flank ecchymosis (Grey Turner’s Sign) suggests the seepage of blood-stained exudates from the pancreas and indicates severe pancreatitis.

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12
Q

Why is it important for pancreatic enzymes to be secreted into the duodenum in an alkaline fluid?
a. To create an optimal environment for enzymatic activity
b. To neutralize acidic chyme from the stomach
c. To accelerate digestion of fats
d. To prevent auto-digestion of the pancreas

A

Answer:
b. To neutralize acidic chyme from the stomach

Rationale:
Pancreatic enzymes are secreted in an alkaline fluid to neutralize the acidic chyme from the stomach, creating an optimal environment for enzymatic activity.

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13
Q

What is the primary function of the exocrine portion of the pancreas, specifically carried out by the acini cells?
a. Production of insulin
b. Synthesis of gastric acids
c. Secretion of alkaline pancreatic juice
d. Storage of bile

A

Answer:
c. Secretion of alkaline pancreatic juice

Rationale:
The exocrine portion of the pancreas, through acini cells, secretes alkaline pancreatic juice that contains various enzymes. This juice helps neutralize acidic chyme from the stomach and provides an optimal environment for enzymatic activity in the small intestine during digestion.

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14
Q

How are pancreatic enzymes secreted into the duodenum?
a. In an acidic fluid
b. In a basic fluid
c. In an alkaline fluid
d. In a neutral fluid

A

Answer:
c. In an alkaline fluid

Rationale:
Pancreatic enzymes are secreted into the duodenum in an alkaline fluid, which neutralizes the acidic chyme coming from the stomach, creating an optimal environment for enzymatic activity.

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15
Q

What is the primary function of the Ampulla of Vater?
a. Storage of bile
b. Synthesis of pancreatic juice
c. Mixing of gastric acids
d. Meeting point for common bile duct and pancreatic duct

A

Answer:
d. Meeting point for common bile duct and pancreatic duct

Rationale:
The Ampulla of Vater is a small reservoir where the common bile duct and pancreatic duct meet. Its primary function is to collect bile from the liver and pancreatic juice from the pancreas before releasing them into the duodenum for digestion.

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16
Q

During hospital admission hx, a nurse suspects acute pancreatitis when a 40-year-old client reports:

a. sudden onset of intense pain in the upper left abdominal quadrant that radiates to the back.
b. persistent abdominal pain in the lower abdomen that has shifted to the lower right quadrant.
c. bloody diarrhea and colicky abdominal pain.
d. mild upper abdominal pain and projectile vomiting.

A

Answer: a.
Rationale: The predominant symptom of acute pancreatitis is severe, deep or piercing, continuous abdominal pain in the ULQ. The pain may radiate to the back because of the retroperitoneal location of the pancreas. Middle-age individuals are at increased risk for developing acute pancreatitis.

17
Q

A nurse is assessing a client with acute pancreatitis and observes a bluish discoloration on the flanks. What is the term for this clinical finding, and what does it suggest about the client’s condition?
a. Jaundice; indicating liver dysfunction
b. Grey Turner’s sign; indicating severe disease process
c. Cullen’s sign; indicating gastrointestinal bleeding
d. Petechiae; indicating thrombocytopenia

A

Answer:
b. Grey Turner’s sign; indicating a severe disease process

Rationale:
Grey Turner’s sign is a bluish flank discoloration associated with acute pancreatitis. It occurs due to the seepage of blood-stained exudates from the pancreas into the retroperitoneal space. This finding suggests a severe disease process and is indicative of possible complications related to acute pancreatitis.

18
Q

A nurse observes a bluish discoloration around a patient’s umbilicus during the assessment for acute pancreatitis. What is the term for this clinical finding, and how does it differ from Grey Turner’s sign in terms of its location?
a. Jaundice; indicating liver dysfunction
b. Cullen’s sign; involving the peritoneal ligaments
c. Murphy’s sign; suggestive of gallbladder inflammation
d. Turner’s sign; indicative of severe pancreatitis

A

Answer:
b. Cullen’s sign; involving the peritoneal ligaments

Rationale:
Cullen’s sign is characterized by a bluish discoloration around the umbilicus and is caused by blood tracking along the peritoneal ligaments. This differs from Grey Turner’s sign, which manifests as a bluish discoloration on the flanks. While both signs are associated with severe pancreatitis, they occur in different abdominal locations.

19
Q

Question 2:
A client with a history of acute pancreatitis is eager to resume oral intake after being on NPO. What assessment findings suggest that the client is ready to start eating again?
a. Presence of mild abdominal discomfort
b. Persistent elevated serum enzyme levels
c. Controlled pain and decreasing serum enzyme levels
d. Complaints of increased nausea and vomiting

A

Answer:
c. Controlled pain and decreasing serum enzyme levels

Rationale:
The client is ready to resume oral intake when pain is controlled, and serum enzyme levels are decreasing. These indicators suggest that the pancreas is healing and the risk of exacerbating inflammation is reduced.

Persistent elevated serum enzyme levels and increased nausea and vomiting may suggest ongoing pancreatic inflammation.

20
Q
A