Pancreas Pathology

Question 1

Name the key cells of the pancreas

Answer 1

islet cells secrete hormones
exocrine cells secrete enzymes

Question 2

What islet cells secrete what hormone ?

Answer 2

alpha cells = glucagon = 20%
(increases blood glucose)
beta cells = insulin = 70%
(decreases blood glucose)
delta cells = somatostatin = 5-10%
(inhibits release of other islet cell hormones, inhibits GH and TSH release)
PP cells = pancreatic polypeptide = <1%
(stimulates gastric chief cell activity)

Question 3

Define DM

Answer 3

diabetes mellitus
hyperglycaemia due to a lack of insulin or insulin that does not function correctly

Question 4

Give the CS of DM

Answer 4

polyuria, polydipsia, polyphagia, weight loss

Question 5

Treatment options for DM

Answer 5

insulin injections
dietary modifications
correction of obesity exercise
oral hypoglycaemic medications

Question 6

Define Type 1 DM

Answer 6

permanent hypoinsulinaemia, with no increase in serum insulin even and an absolute necessity for exogenous insulin to maintain control of glycemia

Question 7

Define Type 2 DM

Answer 7

heterogenous disease attributable to impaired insulin action and B-cell failure
more of an environmental role

Question 8

Histological signs of DM

Answer 8

islets replaced by amyloid
severe T-lymphocytes infiltrations within islets

Question 9

Define a nesidioblastisis

Answer 9

a non-neoplastic proliferation of islet and ductular tissue, typically incidental

Question 10

Name and describe the most common pancreatic endocrine neoplasm

Answer 10

Insulinomas
functional tumours that produce multiple hormones (undetected often !)
difficult to distinguish if benign or malignant (in dogs almost all are malignant)

Question 11

Name other examples of pancreatic tumours

Answer 11

glucagonoma (alpha cells)
insulinoma (beta cells)
somatostatinoma (delta cells)
PPoma (pancreatic polypeptide-secreting islet neoplasm, PP cells)