Pancreatic Exocrine Function

Question 1

What is the function of bicarbonate in our body?

Answer 1

Bicarbonate is a base

Critical for neutralising acid that comes into the small intestines from the stomach

Question 2

What is the secretion of bicarbonate dependent on?

Answer 2

Carbonic anhydrase

Question 3

What is protein digestion initiated by?

Answer 3

Pepsin in the stomach

Question 4

What are the two main pancreatic proteases?

Answer 4

Trypsin
Chymotrypsin

Question 5

What are pancreatic proteases stored as?

Answer 5

Proenzymes
(Trypsinogen and Chymotrypsinogen)

Question 6

What is trypsinogen activated by?

Answer 6

Enterokinase

Question 7

What does trypsin activate?

Answer 7

Chymotrypsinogen
Additional trypsinogen

Question 8

What is the function of lipases?

Answer 8

Hydrolyse triglycerides to monoglycerides and free fatty acids

Question 9

What is the function of bile salts?

Answer 9

Aid triglyceride digestion and absorption of monoglycerides and free fatty acids

Question 10

What is fat digestion dependent on?

Answer 10

Pancreatic and hepatic secretion

Question 11

What is the function of amylase?

Answer 11

Hydrolyses starch to maltose and malotriose and limit dextrins

Question 12

What is the major source of amylase?

Answer 12

Pancreas

Question 13

What is the major source of amylase?

Answer 13

Pancreas

Question 14

What are the two stages of the stimulation of enzyme secretion?

Answer 14

Cephalic Stage - Anticipatory stage, you know a meal is coming and the vagus nerve tells you ( you start to salivate etc) salivary amylase and gastrin produced

Low level stimulus anticipation of a meal

Question 15

What happens in the intestinal stage of enzyme secretion?

Answer 15

Secretin, Cholecystokinin and Gastrin are produced

Question 16

What is cholecystokinin stimulated by?

Answer 16

HCl, Protein and Fats entering the duodenum

Question 17

Where is cholecystokinin produced?

Answer 17

I cells of duodenum and jejunum

Question 18

What is the function of cholecystokinin?

Answer 18

Gallbladder contraction

Inhibition of gastric acid secretion

Delays gastric emptying

Question 19

What is secretin stimulated by?

Answer 19

Low duodenal pH

Question 20

Where is secretin produced?

Answer 20

Upper small intestine

Question 21

What is the function of secretin?

Answer 21

Pancreatic water and bicarbonate secretion (carrying enzymes)

Question 22

What is gastrin stimulated by?

Answer 22

Gastrin distension and irritation

Question 23

Where is gastrin produced?

Answer 23

G cells in stomach

Question 24

What is the function of gastrin?

Answer 24

HCl secretion (parietal cells) enzyme release (acinar cells)

Question 25

What are symptoms of pancreatic exocrine insufficiency?

Answer 25

Maldigestion Diarrhoea Steatorrhoea Weight loss

Question 26

What are consequences of pancreatic exocrine insufficiency?

Answer 26

Malnutrition Osteoporosis Increased cardiovascular morbidity Symptom burden

Question 27

What are the steps of a pancreatic function assessment?

Answer 27

History, risk factors Imaging Faecal elastase Markers of malnutrition

Question 28

What are steps for treatment of PEI?

Answer 28

Pancreatic enzyme replacement therapy STOP smoking Bone health assessment Treat the underlying cause