pancreas funciton

Question 1

true of false
the pancreas is not in the GI tract

Answer 1

true
- involved in digestion but not in the GI

Question 2

define purpose of exocrine tissues

Answer 2

production of enzymes used in digestive process

Question 3

describe purpose of endocrine tissue

Answer 3

production of insulin and glucagon

Question 4

describe the ampulla of vater

Answer 4

meeting point of common bile duct and pancreatic duct where liver and pancreas combine enzymes

Question 5

which of the tissues in the pancreas is a higher percent of total tissue

Answer 5

exocrine - 98% of tissue -> enzyme secreting

Question 6

describe the formation of endocrine tissue

Answer 6

islet of langerhans holding hormone release cells (alpha, beta, gamma cells etc)
- responsible for hormone release

Question 7

list hormones secreted by islet cells in endocrine tissue

Answer 7

• alpha: glucagon
• beta: insulin
• delta: somatostatin
• gamma: pancreatic polypeptide hormones
• epsilon: ghrelin

Question 8

describe formation of exocrine tissue

Answer 8

• formed of acinar glands (flowers around islets)
• secrete enzymes
• form alkaline pancreatic fluid to counteract stomach acidity

Question 9

describe secretin

Answer 9

• synthesized in response to acid stomach contents
• responsible for alkaline pancreatic fluid (lining protection)

Question 10

describe CCK

Answer 10

• produced by cells of intestinal mucosa
• stimulates release of bile into intestines and enzyme release from acinar cells

Question 11

list the 3 disease states that cause 95% of medical attention to the pancreas

Answer 11

• cystic fibrosis
• pancreatic carcinoma
• pancreatitis

Question 12

how does disease of the pancreas impact function

Answer 12

• diminish exocrine function
• diminished digestion/absorption

Question 13

describe cystic fibrosis

Answer 13

• dysfunction of mucous exocrine glands
• CFTR gene on chromosome 7
• ducts of acini to dilate and convert into cysts filled with mucous
• prevents pancreatic secretion from reaching duodenum

Question 14

describe pancreatic carcinoma

Answer 14

• adenocarcinoma of ductal epithelium (most common)
• tumor spreads from head to body to cause problems

Question 15

descibe enzyme increases in acute pancreatitis

Answer 15

increase in amylase, lipase and trigs

Question 16

describe endocrine tests

Answer 16

reflect changes in endocrine cells of pancreas
- gastin, insulin and glucose

Question 17

describe exocrine tests

Answer 17

suspected with increased amylase and lipase

Question 18

describe CCK test

Answer 18

direct determination of exocrine secretory capsicity of pancreas

Question 19

describe fecal fat

Answer 19

• qualitive screening with fat suluble stains
• sudan stains neutral fats yellow-orange

Question 20

name the definitive test for steatorrhea

Answer 20

quantitative fecal fat analysis

Question 21

describe fecal elastase-1

Answer 21

non invasive indirect indicator of moderate and severe exocrine pancreatic dysfunction

Question 22

serum enzymes - lipase

Answer 22

• exclusive pancreatic test
• increases w/in 24 hours of acute pancreatitis
• not cleared quickly
• pancreatic disease detection

Question 23

serum enzymes - amylase

Answer 23

• cleared by kidneys
• urine amylase more sensitive than serum
• ordered with lipase
• increases w/in 3-6 hours of acute pancreatitis
• UA increase of 8-9% = acute

Question 24

renal clearance of amylase

Answer 24

minor intermittent increases in serum levels
- increases (8-9%) in acute pancreatitis, burns, sepsis and diabetic ketoacidosis

Question 25

gastrin

Answer 25

• peptide hormone, G cells of duodenum
• Zollinger-Ellison diagnosis

Question 26

when would sweat chloride testing be appropriate

Answer 26

• cystic fibrosis suspicion
  -> CF patients have a reduced ability to reabsorb Cl from sweat due to mutation of chloride transporter