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Digestion > Section 2C > Flashcards

Section 2C Flashcards

0
Q

Role of the “exocrine” pancreas?

A

Produce pancreatic juice

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1
Q

Endocrine pancreas produces what two things and is involved in what important role in the body?

A

Production of Insulin and Glucagon

Involved in plasma glucose regulation

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2
Q

What two main things make up the pancreatic juice

A

HCO3 to neutralize the gastric acid

Many digestive enzymes

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3
Q

What is the pH of pancreatic juice?

A

7.6-8.2

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4
Q

Pancreatic juice travels from the pancreas to what organ via what duct?

A

To the small duodenum via the main pancreatic duct

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5
Q

About how much pancreatic juice is secreted per day

A

About 1500 mL

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6
Q

Other than pancreatic juice, what other two secretions help neutralize gastric acid in the small intestine? What do they raise the pH in the duodenum to?

A

Bile and Intestinal juices

pH: raised to 6.0-7.0

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7
Q

What two sphincters combine to form the sphincter of Oddi?

A

Bile duct sphincter

Pancreatic duct sphincter

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8
Q

Name the 9 specific enzymes found in pancreatic juice

A
  1. Pancreatic amylase
  2. Pancreatic lipase
  3. Colipase
  4. Trypsinogen
  5. Chymotrypsinogen
  6. Procarboxypeptidase
  7. Proelastase
  8. Ribonuclease
  9. Deoxyribonuclease
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9
Q

What state are proteases in when secreted in the pancreatic juice?

A

They are “inactive” pro-enzymes that need to be activated

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10
Q

What is the active form of Trypsinogen and what enzyme catalyzes the reaction? When does this activation occur?

A

Trypsinogen –> Trypsin
Enzyme: Enterokinase (also known as Enteropeptidase)
Occurs when the pancreatic juice enters the duodenum

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11
Q

Trypsin is important. What three enzymes does trypsin activate and what is their activated name?

A
  1. Chymotrypsinogen –> Chymotrypsin
  2. Procarboxypeptidase –> Carboxypeptidase
  3. Proelastase –> Elastase
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12
Q

An Enterokinase deficiency may lead to what?

A

It may occur as a congenital abnormality, which leads to protein malnutrition

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13
Q

What are trypsin inhibitors and why are they important?

A

Trypsin inhibitors block the action of trypsin. They are found in pancreatic tissue in case trypsin leads to a chain reaction of pancreatic enzymes becoming active that are capable of digesting the pancreas

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14
Q

Secretions of pancreatic juice are primarily under what type of control?

A

Hormonal control

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15
Q

What is the difference in affects of Secretin and CCK on the makeup of pancreatic juice?

A

Secretin: stimulates pancreas to make pancreatic juice that is RICH in HCO3- and LOW in enzymes
CCK: Stimulates pancreas to make pancreatic juice LOW in HCO3- and RICH in enzymes

16
Q

Is there any neural control in the release of pancreatic juice? Is it rich in HCO3- or Enzymes?

A

Yes, stimulation of the parasympathetic fibers within the vagus nerve also causes secretion of a small amount of pancreatic juice that is RICH in enzymes. Its influence is less potent than CCK

17
Q

What is acute pancreatitis

A

A severe, life-threatening disorder associated with the escape of activated pancreatic enzymes into the pancreas and surrounding tissues

18
Q

What two enzymes are useful in measuring in the plasma to diagnose inflammation and necrosis of pancreatic acinar cells

A

Pancreatic amylase or Pancreatic lipase

19
Q

Pancreatic juice enzymes cause what to occur during pancreatitis

A

The enzymes cause fat necrosis, or autodigestion, of the pancreas and produce fatty acid deposits in the abdominal cavity and hemorrhage from the necrotic vessels.

20
Q

What is the most common causes of pancreatitis?

A

Gallstones or Alcohol abuse

21
Q

How may alcohol lead to pancreatitis?

A

It is known to be a potent stimulator of pancreatic juice

It is also known to cause contraction of the sphincter of Oddi

22
Q

Acute pancreatitis is also associated (to a lesser degree) with 6 other things?

A
  1. Hyperlipidemia
  2. Hyperparathyroidism
  3. Viral infections
  4. Abdominal trauma
  5. Surgical trauma
  6. Drugs such as steroids and thiazide diuretics
23
Q

What drugs are also associated with acute pancreatitis?

A

Steroids

Thiazide diuretics

24
Q

What is the most common initial symptom of pancreatitis?

A

Severe epigastric and abdominal pain that radiates to the back

25
Q

The commonly used term pancreatic cancer usually refers to what?

A

A ductal adenocarcinoma of the pancreas

26
Q

More than 95% of malignant neoplasms of the pancreas arise from what?

A

Exocrine elements and are referred to as exocrine pancreatic cancers

27
Q

The 3 most common presenting symptoms in patients with exocrine pancreatic cancer are what?

A
  1. Pain
  2. Jaundice
  3. Weight loss
28
Q

Approximately 60-70% of exocrine pancreatic cancers are located where? 20-25% where?

A

60-70%: Head of the pancreas

20-25%: Body and tail

29
Q

What is the only potentially curative treatment for exocrine pancreatic cancer? How successful is it?

A

Surgical resection but because of the late presentation of the disease, only 15-20% patients are candidates for pancreatectomy.

30
Q

What are the 3 major risk factors for pancreatic cancer:

A
  1. Cigarette smoking
  2. High body mass and lack of physical activity
  3. History of chronic pancreatitis
31
Q

Is pancreatic cancer genetic?

A

Possibly, at least 5-10% of patients have a 1st degree relative with the same disease

32
Q

What is the most common lethal genetic disease among whites?

A

Cystic fibrosis

33
Q

What causes cystic fibrosis?

A

A defect in Cl- channels that is caused by a mutation in the cystic fibrosis transmembrane conductance regulator (CFTR) gene

34
Q

What is characteristic of cystic fibrosis?

A

Malfunction of exocrine glands

This results in increased viscosity of mucus and increased chloride concentration in sweat and tears

35
Q

What are three clinical manifestations of cystic fibrosis?

A
  1. Chronic pulmonary disease
  2. Pancreatic insufficiency
  3. Meconium Ileus
36
Q

What is an important diagnostic test for cystic fibrosis?

A

The sweat test

Digestion (15 decks)

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