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GI > Pancreatitis and Pancreatic Secrections > Flashcards

Pancreatitis and Pancreatic Secrections Flashcards

1
Q

What are the main causes of acute pancreatitis?

other causes?

A

Alcohol use & gallstones

  • autoimmune
  • hyperlipidemia/hypercalcemia
  • infection (ex. mumps)
  • drugs (azathioprine, estrogen, DDI)
  • ischaemia
  • pancreas divisum
  • CFTR
  • trauma/post-procedure ERCP
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2
Q

When/how does it progress?

A

Usually is self-limited and non-progressive

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3
Q

Describe pain due to pancreatitis.

A

“Boring” pain - may go straight through to back.

Constant pain - not wavering

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4
Q

What are some lab tests that should be ordered to diagnose pancreatitis?

A
  • amylase/lipase
  • liver enzymes
  • CBC
  • electrolytes, creatinine, phosphate, calcium
  • lipid profile
  • blood cultures (if febrile)
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5
Q

What is the treatment for acute pancreatitis?

A
  • avoid alcohol
  • supportive therapy
  • address underlying problem –> analgesia
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6
Q

What is the endocrine function of the pancreas?

What part of the pancreas is responsible for endocrine function?

A

Secreting hormones such as insulin & glucagon into blood.

Tail.

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7
Q

What is the endocrine function of the pancreas?

What part of the pancreas is responsible for exocrine function?

A

Secreting digestive enzymes into the duodenum.

Head.

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8
Q

Briefly describe chronic pancreatitis.

A

Permanent structural damage with impaired exocrine and endocrine function.
Appears as progressively patchy fibrosis.
Amylase/Lipase usually normal.

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9
Q

Briefly describe the pathophysiology of chronic pancreatitis.

A

Multiple mechanisms:

  1. Decreased HCO3- secretion (ex. CFTR) & increased protein secretion
    - -> causes plugs focally in small ducts
    - -> leads to stone formation, scarring, & obstruction
  2. Mechanical blockage of ducts
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10
Q

Why does alcohol lead to pancreatitis?

A

Causes change in phenotype of secretions

  • -> less HCO3-
  • -> thicker secretions
  • -> plugs ducts
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11
Q

Why is there so much pain with pancreatitis?

A

Pancreas is directly over the celiac plexus so and inflamed pancreas may trigger these nerves.

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12
Q

What cell types in the pancreas have an exocrine function?

A

Acini & ducts –> produce enzymes and bicarb

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13
Q

What cell types in the pancreas have an endocrine function?

A

Islets (no ducts) –> insulin & glucagon

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14
Q

What is the exocrine functional unit of the pancreas called?

A

Pancreon

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15
Q

What cells make up the pancreon?

A
  • acinar cells
  • centroacinar cells
  • stellate cells
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16
Q

What are the lipolytic enzymes in the pancreas?

A

lipase
procolipase
cholesterolase
prophospholipase

17
Q

What are the proteolytic enzymes in the pancreas?

A

trypsinogen
chymotrypsinogen
proelastase
procarboxypeptidase

18
Q

What are the nuclease enzymes in the pancreas?

A

Ribonuclease

deoxyribonuclease

19
Q

What are the amylolytic enzymes in the pancreas?

A

alpha-amylase

20
Q

What enzyme is responsible for activating the majority of pancreatic enzymes?
Where do they get activated?

A

Trypsin

in duodenum

21
Q

What activates trypsin?

A

Enteropeptidases in the brush border.

22
Q

What produces CCK, VIP, & Secretin?

A

Enteroendocrine cells

- in stomach and duodenum

23
Q

What stimulate secretion of CCK?

A

Amino and fatty acids entering the duodenum

24
Q

What stimulates secretion of Secretin?

A

Presence of H+ in the duodenum stimulates

25
Q

What is the hormonal function of CCK?

A

Acts on acinar cells to release digestive enzymes

26
Q

What is the hormonal function of Secretin?

A

Stimulates centroacinar and duct cells to release HCO3-

27
Q

What is the neural path/function of CCK?

A

Stimulates Nodose Ganglion

  • -> stimulates Dorsal Vagal Motor Nucleus
  • -> stimulates Intrinsic Ganglia
  • -> uses NT (ACh) to stimulate acinar cells to release digestive enzymes
28
Q

What is the neural response to the sight/smell/thought of food?

A

Stimulation of Dorsal Vagal Motor Nucleus

  • -> Stimulates Intrinsic Ganglia
  • -> releases Ach at acinar cells; releases ACh & VIP at ductal cells
  • -> stimulates release of digestive enzymes & HCO3-
29
Q

How do stretch receptors in the stomach act neurally?

A
  • -> Stimulate Nodose Ganglion
  • -> stimulate Dorsal Vagal Motor Nucleus
  • -> stimulate Intrinsic Ganglia
  • -> Ach (&VIP) acts on acinar cells (&ductal cells)
  • -> release of digestive enzymes (or HCO3-)

GI (13 decks)

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