Pancreas Cudental Revised

Front 1

The enzymes ______, _____ and _______ are synthesized in pancreatic acini and are released in an inactive form.

Back 1

amylase, lipase, peptidase (trypsin, chymotrypsin)

Front 2

____________ stimulates secretion of pancreatic enzymes.

Back 2

CCK (cholecystokinin)

Front 3

_________ stimulates the release of bicarbonate.

Back 3

Secretin

Front 4

t/f Pancreatic enzymes are found in trace amounts in the normally; elevated levels of these enzymes can be an indicator of pancreatic disease.

Back 4

True; True

Front 5

Cystic fibrosus affects mucous secretions and plugs ducts. This leads to ____ of the pancrease resulting in ________.

Back 5

atrophy, malabsorptioin

Front 6

Pacreatitis is inflamationof the endocrine pancrease. T/F

Back 6

False - exocrine**

Front 7

Fat necrosis, pseudocysts and calcium soaps (hypercalcemia) result from the autodigesttion of the pancrease due to ____ _______.

Back 7

acute pancreatitis

Front 8

Increased serum ________ and _______is indicitave of acute pancreatitis.

Back 8

amylase, lipase

Front 9

80% of the cases of acute pancreatitis are due to _______ and _______; the cause of the other 20% is ___________

Back 9

gallstones, excessive alcohol; idiopathic

Front 10

70-80% of chronic pancreatitis is associated with _________ or __________ leading to progessive fibrosis and calcification causing ________.

Back 10

alcohol abuse, cholecystitis, malabsorption

Front 11

Chronic pancreatits may also cause destruction of the islet cells leading to secondary _____.

Back 11

diabetes

Front 12

Systenic organ failure, DIC, abscesses, pseudocysts and duodenal obstruction are characteristic of _______.

Back 12

acute pancreatitis

Front 13

Chronic pancreatitis displays pseudocysts and duct obstruction (same as acute) but also causes secondary diabetes and ________.

Back 13

malabsorption

Front 14

_____% of pancreatic neoplasms are malignant and rarely occur under age _____.

Back 14

95%, age 40

Front 15

A patient presents with abdominal pain radiating to the back, obstrutive jaundice; distended palpable gallbladder and weight loss. What do you suspect?

Back 15

pancreatic cancer

Front 16

Adenocarcinomas are usually located at the _____ of the pancrease tending to obstruct the ______ causing jaundice. They also metastasize _____.

Back 16

head, common bile duct, early

Front 17

90% of insulinomas, also called ____ _____ tumors, are (malignant or benign) and show signs similar to diabetes.

Back 17

beta cell tumors, benign

Front 18

The most common endocrine tumor is insulinoma. T/F

Back 18

TRUE

Front 19

Glucagonoma is also called an ______ _______ tumor and is usually (benign or malignant)

Back 19

alpha cell tumor; benign

Front 20

One of the most best indicators for pancreatic tumors is ______.

Back 20

jaundice

Front 21

Zollinger Ellison syndrome is caused by ____________ usually due to a gastrinoma.

Back 21

recurrent peptic ulcers

Front 22

Somatostatinomas are ____ cell tumors and present with mild diabetes, malabsorption, etc.

Back 22

Delta

Front 23

Diabetic synptoms include the 3 P's: polydipsia (thirst), polyuria and ______.

Back 23

polyphagia - hotcoles is a phag

Front 24

type of diabetes: Sudden onset (90% have complications in first two years)

Back 24

type 1

Front 25

type of diabetes: after age 30

Back 25

type 2

Front 26

type of diabetes: obese

Back 26

type 2

Front 27

type of diabetes: no endocrine cell antibodies

Back 27

type 2

Front 28

type of diabetes: amyloidosis

Back 28

type 2

Front 29

type of diabetes: low insulin levels

Back 29

type 1

Front 30

type of diabetes: normal body weight

Back 30

type 1

Front 31

type of diabetes: normal to increased insulin levels

Back 31

type 2

Front 32

type of diabetes: antibodies to beta cells

Back 32

type 1

Front 33

type of diabetes: familiary history more common

Back 33

type 2 (60%) - type 1 is only (20%)

Front 34

Ketoacidosis is common in type ____ diabetes but not in type ____.

Back 34

ketoacidosis - common in I, not in 2

Front 35

Less complications are seen in type ___ diabetes

Back 35

2

Front 36

there is a _____% concordance in twins with type 1 diabetes and a ____% concordance in twins with type II

Back 36

50% (type I), 90% (type II)

Front 37

Type 2 diabetes show increased insulin resistance in ____ and _____.

Back 37

fat, muscle especially

Front 38

Pancreatic carcinoma, chronic _________, endocrine diseases, steroids, bronze disease, cushing's syndrome, acromegaly, glucagonoma and _________ can cause seconday diabetes

Back 38

pancreatitis, pregnancy

Front 39

Complications of poorly controlled diabetics include kidney, cardiovascular, eye hemorrhages and nervous system problems. T/F

Back 39

True; True

Front 40

________ necrosis / polynephritis is often a result of diabetes.

Back 40

Papillary

Front 41

Cariovascular problems caused by diabetes include atherosclerosis, peripheral vascular insufficiency (gangrene) and more commonly _____.

Back 41

MI's

Front 42

Amyloidosis is common in type __ diabetes; and fibrosis is common in type ___.

Back 42

II, I

Front 43

t/f it is more common to see a hypoglycemic diabetic patient than hyperglycemic?

Back 43

true (according to dr hess)

Front 44

How can you assess if a patient is well controlled diabetic?

Back 44

acts them what their Hba1c is (yes, "acts" was written for you coles)

Front 45

Normal fasting glucose level is _____ mg/dl

Back 45

60-100

Front 46

A glucose level of ______ is considered elevated and _______ severely elevated.

Back 46

180-240, >250

Front 47

Define HbA1c?

Back 47

% of glycosylated hemoglobin

Front 48

What are the normal values of HbA1c?

Back 48

normal is below 6.5%

Front 49

Elevated A1c is ______ and severley elevated is ______

Back 49

8.5-10%, and 10.5-14%

Front 50

Which of the following will NOT help better manage a diabetic patient? Morning appointments, asking what symptoms they show when hypoglycemic, checking if their A1c level is elevated, providing insulin before treatment.

Back 50

you shouldn't give them insulin (duuh mas) and elevated glucose levels are what you want, not elevated Hba1c. Hba1c should be as low as possible

Front 51

The kidney basement membrane becomes thicker and less permeable with poorly controlled diabetes. T/F

Back 51

false ; becomes thicker, but more permeable -->nephrotic syndrome

Front 52

_____________ disease (diffuse glomerulosclerosis) is common in people with long standing diabetes and affects the ________ (which organ of the body)

Back 52

Kimmelsteil wilson, kidney

Front 53

Which of the following is not an anatomic change in diabetic patients: cataracts, peripheral neuropathy, fatty change in liver, xanthoma, abcesses/fungal lesions, gangrene.

Back 53

all are symptoms

Front 54

Which is not a symptom of hyperglycemia: thirst, polyurea, hunger, blurred vision, sweating, nausea and drowsyness.

Back 54

sweating is a sign of hypo-glycemia

Front 55

Which is not a symptom of hypoglycemia: sweating, anxiety, tremors, nausea, confusion and headache.

Back 55

all are symptoms