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Digestive System > Pancreatitis > Flashcards

Pancreatitis Flashcards

1
Q

What clinical signs / syndromes might you see in an animal with pancreatitis?

A 
Weight loss
Melena +/- diarrhoea
PU/PD 
Fat, muscle fibres in faeces 
Abdominal pain
Dehydration
Vomiting
Depressed
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2
Q

What are two trypsin inhibitors? Where are they present?

A

Alpha-1 protease inhibitor

Pancreatic secretory trypsin inhibitor

Present in ductal and acinar secretions

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3
Q

How is trypsinogen activated to trypsin?

A

Enterokinase in GI lumen

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4
Q

What are three defenses of the pancreas to autodigestion other than trypsin inhibitors?

A

Confinement of enzymes in zymogen granules
Synthesis of some enzymes in inactive form
Degradation of zymogen granules if release is inhibited
Resistance of acinar cells to trypsin, chymotrypsin and PLA2

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5
Q

Which two cell types may undergo mitosis to replace lost acinar cells?

A

Remaining acinar cells

Ductal epithelium

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6
Q

What is the most clinically significant of the congenital pancreatic diseases?

A

Pancreatic hypoplasia.

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7
Q

Which trace element deficiencies can cause primary pancreatic atrophy?

A

Zinc, selenium, copper

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8
Q

What is the difference between primary and secondary pancreatic atrophy?

A

Secondary atrophy results from concurrent pancreatic disease, usually non-uniform distribution

Primary atrophy due to dietary deficiency or something, uniform distribution

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9
Q

What is the usual mechanism for secondary pancreatic atrophy?

A

Obstruction of ducts

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10
Q

What is juvenile pancreatic atrophy?

A

Inherited autosomal recessive premature atrophy of pancreatic parenchyma - GSD

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11
Q

What is the presumed mechanism for atrophy in JPA? Are the islets of langerhans affected?

A

Autoimmune attack on pancreatic tissue (lymphocytic)

Usually the islets are unaffected, though increased in prominence

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12
Q

What is believed to lead to the majority of EPI cases in dogs?

A

Juvenile pancreatic atrophy

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13
Q

What is believed to lead to the majority of EPI cases in cats?

A

Chronic subclinical pancreatitis

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14
Q

What are three clinical signs that might be seen in dog with EPI (4 things)?

A

Chronic weight loss despite large appetite
Pica
Coprophagia
Pale, voluminous faeces +/- diarrhoea

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15
Q

What are two rare but potential consequences of EPI if left untreated?

A

Mesenteric torsion due to distended, voluminous intestinal contents

Coagulopathy due to vitamin K not being absorbed

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16
Q

What is one major consequence of untreated EPI?

A

Small intestinal bacterial overgrowth due to presence of undigested substrate in the lumen > SI dysfunction

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17
Q

Other than dogs, which species may be afflicted by acute pancreatic necrosis?

A 
Cats
Horses
Pigs
Mice
Primates
18
Q

What is the term for undigested muscle fragments?

A

Creatorrhoea

19
Q

What is the term for undigested starch fragments?

A

Amylorrhoea

20
Q

How could elevated blood triglycerides play a role in triggering acute pancreatic necrosis?

A

Clog capillaries supplying the pancreatic parenchyma > hypoxia and degeneration

21
Q

What nutrition risk factors predipose to pancreatitis?

A

Obesity
High fat meal/diet
Low protein diet

22
Q

What iatrogenic risk factors predipose to pancreatitis?

A

Corticosteroids

23
Q

What toxic risk factors predipose to pancreatitis?

A

Zinc poisoning

Cassida occidentalis in pigs

24
Q

What other risk factors predipose to pancreatitis?

A

High rise syndrome in cats, pancreatic trauma generally
Hypercalcemia
Uraemia
Hyperadrenocorticism

25
Q

What are some of the signs a dog with acute pancreatic necrosis may present with?

A 
Anorexia
Depression
Abdo pain
Vomiting
Dehydration
Haemorrhagic diarrhoea
26
Q

What are some of the signs a cat with acute pancreatic necrosis may present with?

A

Anorexia, lethargy, depression, dehydration, tachypnoea, hypothermia

27
Q

What are some gross lesions that may be seen in specimens of acute pancreatic necrosis?

A 
Fat necrosis of peripancratic fat
Oedema of pancreas and its mesentery
Multifocal petechial haemorrhages
Hyperaemic pancreas
Fibrinous exudate
28
Q

What is one potential consequence of fibrosis following an episode of acute pancreatic necrosis?

A

Obstruction of the common bile duct > jaundice

29
Q

What are some potential consequences of acute pancreatic necrosis?

A 
DIC
Renal failure (acute)
Paralytic ileus
Secondary bacterial infection
EPI
Diabetes mellitus
30
Q

What form of pancreatic necrosis is thought to be caused by reflux of duodenal contents up the pancreatic duct?

A

Acute haemorrhagic pancreatic necrosis

31
Q

What are the three non-necrotising forms of pancreatitis?

A

Focal, multifocal and interstitial

32
Q

What is one potential cause of focal pancreatitis?

A

Stephanurus dentatus (pigs) may encyst in pancreaas on way to/from liver to provoke intense local suppurative inflammation

33
Q

Is haematogenous spread of infection to the pancreas common?

A

No

34
Q

What can cause multifocal pancreatitis?

A

Epitheliotrophic viral infectious e.g canine distemper, foot and mouth disease, adenovirus

Systemic toxoplasmosis (esp. cats)

FIP infection (cats)

35
Q

What can pancreatitis as a result of foot and mouth disease mean for the ruminant?

A

May develop diabetes mellitus

36
Q

What is generally the trigger for chronic lymphocytic interstitial pancreatitis? Which species are most commonly affected?

A

Ascent of bacteria up the pancreatic duct from the intestine
Cats and horses
- as the pancreatic duct enters the duodenum with or close to the bile duct, common to also see cholangitis and cholangiohepatitis

37
Q

Which species most commonly develop pancreatic calculi?

A

Cattle

38
Q

What is an example of a pancreatic duct parasite?

A

Ascarid (roundworm nematode) in pigs and dogs

39
Q

What is the cause for pancreatic nodular hyperplasia of exocrine cells?

A

Idiopathic - old cats, dogs, cattle

40
Q

What is the most common neoplasm of the pancreas?

A

Exocrine pancreatic adenocarcinoma

Digestive System (12 decks)

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