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Clinical Chemistry > Pancreas & GI System > Flashcards

Pancreas & GI System Flashcards

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1
Q

Pancreas endocrine functions

A

insulin
glucagon
somatostatin

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2
Q

pancreas exocrine functions

A

enzymes for digestion & bicarb ion to neutralize acids in intestine
amylase (CHO) & lipase (fats)
trypsin, chymotrypsin, elastase, collegenase, leucine aminopeptidase

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3
Q

pancreas nerve control

A

vagus nerve branches

stimulates small amount of secretions responding to food smell /view

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4
Q

pancreas endocrine control

A

CCK & Secretin

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5
Q

Secretin

A

made in response to HCL acid @ duodenum in small intestine

leads to pancreas release of bicarb ion

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6
Q

CCK

A

cholecystokinin from intestinal mucosa

causes pancreas to release digestive enzymes

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7
Q

pancreatic diseases

A

cystic fibrosis
pancreatic cancer
pancreatitis

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8
Q

Cystic fibrosis

A

dysfunction of mucous & exocrine glands throughout the body
see intestinal obstruction, pulmonary infections & pancreatic malabsorption
ch 7 gene CFTR

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9
Q

sweat chloride test

A

> 60 mEg/L is diagnostic

done at least twice

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10
Q

sweat chloride test

A

> 60 mEg/L is diagnostic
done at least twice
apply pilocarpine to skin, collect sweat, measure

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11
Q

Pancreatic Carcinoma

A

death w/in 1 yr for 90% of diagnosed cases

tumors in tail & body of pancreas missed until advanced

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12
Q

signs of pancreatic carcinoma

A

jaundice (post-hepatic), weight loss, anorexia, nausea
islets of pancreas make excess insulin
overproduction of gastrin in Zollinger-Ellison syndrome

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13
Q

Acute Pancreatitis

A

inflammation of pancreas (usually reversible)

autodigestion of gland due to reflux of bile &/or duodenal contents into pancreatic duct

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14
Q

causes of acute pancreatitis

A 
alcohol abuse
mumps
obstruction of biliary tract
gallstones
pancreatic tumors
atherosclerotic disease
shock
pregnancy
hypercalecemia
immunologic factors associated w/ transplantation
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15
Q

lab tests for acute pancreatitis

A

amylase 2-3x
lipase elevated but as much as amylase
increased triglycerides, variable calcium levels
decreased 02

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16
Q

Chronic pancreatitis most common cause

A

alcohol abuse

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17
Q

chronic pancreatitis signs/symptoms/things associated w/ it

A

edema & fluid buildup in peritoneal cavity w/ associated decrease in blood volume
acinar cells of pancreas become infiltrated by inflammation
can develop hemorrhage & necrosis

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18
Q

chronic pancreatitis labs

A

increased lipase, triglycerides, & calcium

decreased 02

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19
Q

‘give away’ for chronic pancreatitis

A

elevated lipase & normal amylase

hemorrhage is exclusively chronic

20
Q

relapse/recurrent pancreatitis

A

causes similar to acute pancreatitis

either acute or chronic w/ similar labs

21
Q

symptom/lab result that is common to all pancreatitis

A

steatorrhea - greasy feces >5g/24hr fecal fat

& malabsorption

22
Q

pancreatic function testing

A

amylase & lipase
malabsorption using D-xylose
CCK, secretin, fecal fat, trypsin, chymotrypsin
bilirubin & ALP (biliary obstruction)
assays for gastrin, insulin, glucose
secretin clearance test

23
Q

Secretin clearance testing

A

give IV secretin, follow w/ CCK
collect secretions for 30, 60, or 80 mins in either 10 min intervals or as a single pool
measure pH, secretion rate, enzyme activities, & bicarb ion

24
Q

Fecal Fat analysis

A

qualitative testing: lipid stains such as Sudan III, Oil red O, nile blue sulfate
quantitative: collect stool for 3 days & use gravimetric, titrimetric, infrared & nuclear magnetic resonance spectroscopy

25
Q

when is steatorrhea seen?

A

biliary obstruction
pancreatic insufficiency
disease of small intestine

26
Q

gravimetric method

A 
extract fatty acids into organic solvent
aliquot in pre-weighed container
evaporate solvent
weigh residue
take difference in weight
1-7 g/24 hr range
27
Q

Titrimetric method

A

extract saponified lipids, evaporate solven, reconstitute in ethanol, titrate w/ NaOH
results are 20% less than gravimetric method

28
Q

cases w/ amylase increases

A

75% of acute pancreatitis
burns
sepsis
diabetic ketoacidosis

29
Q

parietal cells

A

produce HCl acid & intrinsic factor (facilitates absorption of vit B12 in ileum)

30
Q

Chief cells

A

pepsin cells

make pepsinogen - converted by acid to pepsin to break down proteins

31
Q

G cells

A

produce gastrin in antrum of stomach & duodenum

respond to stimulation from vegas nerve

32
Q

Gastrin stimulation

A

neurogenic impulses= smell, sight, anticipation
distention of stomach w/ food/fluid
contact of protein- breakdown called secretagogues

33
Q

Gastrin inhibited by

A

high gastric acidity
gastric inhibitory polypeptide (GIP) secreted in response to food
vasoactive intestinal polypeptide (VIP)- inhibits everything about gastrin

34
Q

Gastric analysis

A

measure basal acid output (BAO) & peak acid output (PAO)

pentagastrin stimulation - synthetic peptide

35
Q

gastric acid & pernicious anemia

A

no acid present

36
Q

gastric acid & Zollinger-Ellison syndrome

A

hyperacid present
normal range: 50-150 pg/ml
Z-E : 1000-400000 pg/ml

37
Q

Gastric ulcer

A

normal acid output

38
Q

duodenal ulcer

A

increased output for BAO & PAO

39
Q

Small intestine

A

20 feet

absorb nutrients & water through passive & active transport

40
Q

Large intestine

A

5 feet long

water reabsorption & store feces

41
Q

pathology of intestine

A

MALABSORPTION mostly
celiac’s disease, whipple’s disease, crohns disease, primary intestinal lymphangiectasia, ischema, amyloidosis, giardiasis, lactase deficiency, hartnup syndrome

42
Q

Hartnup syndrome

A

defect in transport of phenylalanine & leucine

43
Q

Tests for intestinal function

A 
lactose tolerance test
D-xylose absorption test
serum carotenoids
fat soluble vit assays
albumin
folate &  vit B12 
iron assays 
calcium & magnesium (decreases seen in vit D deficiency)
44
Q

Lactose tolerance test

A

hydrogen ion breath test
acquired deficiency > genetic
cramps, diarrhea, abdominal discomfort

45
Q

D- Xylose test

A

pentose sugar not found in foods
absorbed unaltered by the proximal small intestine & filtered out the kidney unchanged
heat urine to change D-xylose to furfural
react w/ p-bromoaniline
spectro

46
Q

Serum Carotenoids

A

humans express carotenoids of lycopene, xanthophyll, & beta carotene
tell about human lipid absorption

Clinical Chemistry (23 decks)

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