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32 Cards in this Set
- Front
- Back
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where is most of the pancreas located?
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LUQ
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why can you get bile duct obstructino bc of prancreatic cancer?
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bc distal bile duct runs through pancreas
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what is a divisum?
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ventral and dorsal pancreatic ducts are seperated
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what do acinar cells secrete?
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pancreatic enzymes
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what do centroacinar cells and ductla cellls secrete?
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Bicarb and fluids
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what can an acidic duodenum lead to?
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inactivation of pepsin, malabsorption of FAs breakdown of pancreatic enzymes, mucosal damage
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what stim pancreatic enzyme secretion?
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CCK- neurally and hormonally
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what stimulates release of CCK from I cells in the duodenum?
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thinking about food
gastic acid secretion and proteins in the bowel |
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what does secretin do?
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from S cells, it stim release of fluids and HCO3 from pancreas
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what activates trypsinogen to trypsin?
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enterokinase in intestines
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how do different receptors on cel surface activate release of enzymes in zymogens?
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either incre intra cell Ca or the cAMP pathway
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what is in the zymogen that keeps trypsin from becoming active and activating everything?
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trypsin inhibitor
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how does insult to pancreas over come protective mechanisms
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colocalization with typsinogen activation and enzyme activation within the pancreas
NFkB is increase leading to inflammatory response |
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AD incomlete penetrance
mutation in cationic trypsinogen pediatric pt acute pancreaitits calcification increased risk of pancreatic cancer |
hereditary pancreatitis
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what do you measeure to evaluate severity of inflammaroty reponse in acute pancreatitis?
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CRP
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what kind of complications can come from cytokine production in acute pancreatitis?
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injury to lungs, microicirculation, kidney
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what most cases of acute pancreatitis caused by?
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most are alcohol induced and biliary tract disesead
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can hyperlipidemia cause severe acure pancreatitis?
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yeppers
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what is the mech for gallstone pancreatitis?
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stone blcks ampulla, refulux of bile acids into the pancreas OR
pressure phenomenon: insultw |
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what are you livkly to see 24 hrs after insult to pancreas?
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elevated serum lipase, but serum amylase may be normal
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what do you think when amylase and lipase are over 3x upper lim of normal?
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pancreatitis!
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is pancreatitis usually sever?
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no its mild
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what is importat treatment for pancreatitis?
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feeding into small bowel
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where do you feed pt with sever pancreatitis?
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mainly jejunal feedin so you dont stim pan secreteion
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how do you treat autoimmun pancreatist?
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corticosteroids;
it involves parotid and biliary tract |
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what is the best diagnostic test for pancreatitis?
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CT
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what is a pseudocyst?
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a leak of fluid from outside the pnacreas and is encapsulated
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what cofactors play a role in chroinic pancreatitits?
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ALCOHOL and smoking
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what does steatorheaa/malabsorption deptict in chronic pancreatitis?
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End stage bc an insuffiecint amount of enzymes are secred into the intestines: have about 90% of pancrease gone
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what are causes of pain in chronic pancreatitis?
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duodenal or CBD obstruction
stricture pseudocyst acure inflammaroy atak neural inflammation ischemia compartment syndrome |
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MRCP shows pancreatic duct dilated and irrugluar; stone in head of pancrease; calcifications:
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calcifications are pathognomonic for chronic pancreatitis
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how does pancreatic adenocarcinoma present?
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double duct sign, like chornic pancreatitis
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