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55 Cards in this Set

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The enzymes ______, _____ and _______ are synthesized in pancreatic acini and are released in an inactive form.
amylase, lipase, peptidase (trypsin, chymotrypsin)
____________ stimulates secretion of pancreatic enzymes.
CCK (cholecystokinin)
_________ stimulates the release of bicarbonate.
Secretin
t/f Pancreatic enzymes are found in trace amounts in the normally; elevated levels of these enzymes can be an indicator of pancreatic disease.
True; True
Cystic fibrosus affects mucous secretions and plugs ducts. This leads to ____ of the pancrease resulting in ________.
atrophy, malabsorptioin
Pacreatitis is inflamationof the endocrine pancrease. T/F
False - exocrine**
Fat necrosis, pseudocysts and calcium soaps (hypercalcemia) result from the autodigesttion of the pancrease due to ____ _______.
acute pancreatitis
Increased serum ________ and _______is indicitave of acute pancreatitis.
amylase, lipase
80% of the cases of acute pancreatitis are due to _______ and _______; the cause of the other 20% is ___________
gallstones, excessive alcohol; idiopathic
70-80% of chronic pancreatitis is associated with _________ or __________ leading to progessive fibrosis and calcification causing ________.
alcohol abuse, cholecystitis, malabsorption
Chronic pancreatits may also cause destruction of the islet cells leading to secondary _____.
diabetes
Systenic organ failure, DIC, abscesses, pseudocysts and duodenal obstruction are characteristic of _______.
acute pancreatitis
Chronic pancreatitis displays pseudocysts and duct obstruction (same as acute) but also causes secondary diabetes and ________.
malabsorption
_____% of pancreatic neoplasms are malignant and rarely occur under age _____.
95%, age 40
A patient presents with abdominal pain radiating to the back, obstrutive jaundice; distended palpable gallbladder and weight loss. What do you suspect?
pancreatic cancer
Adenocarcinomas are usually located at the _____ of the pancrease tending to obstruct the ______ causing jaundice. They also metastasize _____.
head, common bile duct, early
90% of insulinomas, also called ____ _____ tumors, are (malignant or benign) and show signs similar to diabetes.
beta cell tumors, benign
The most common endocrine tumor is insulinoma. T/F
TRUE
Glucagonoma is also called an ______ _______ tumor and is usually (benign or malignant)
alpha cell tumor; benign
One of the most best indicators for pancreatic tumors is ______.
jaundice
Zollinger Ellison syndrome is caused by ____________ usually due to a gastrinoma.
recurrent peptic ulcers
Somatostatinomas are ____ cell tumors and present with mild diabetes, malabsorption, etc.
Delta
Diabetic synptoms include the 3 P's: polydipsia (thirst), polyuria and ______.
polyphagia - hotcoles is a phag
type of diabetes: Sudden onset (90% have complications in first two years)
type 1
type of diabetes: after age 30
type 2
type of diabetes: obese
type 2
type of diabetes: no endocrine cell antibodies
type 2
type of diabetes: amyloidosis
type 2
type of diabetes: low insulin levels
type 1
type of diabetes: normal body weight
type 1
type of diabetes: normal to increased insulin levels
type 2
type of diabetes: antibodies to beta cells
type 1
type of diabetes: familiary history more common
type 2 (60%) - type 1 is only (20%)
Ketoacidosis is common in type ____ diabetes but not in type ____.
ketoacidosis - common in I, not in 2
Less complications are seen in type ___ diabetes
2
there is a _____% concordance in twins with type 1 diabetes and a ____% concordance in twins with type II
50% (type I), 90% (type II)
Type 2 diabetes show increased insulin resistance in ____ and _____.
fat, muscle especially
Pancreatic carcinoma, chronic _________, endocrine diseases, steroids, bronze disease, cushing's syndrome, acromegaly, glucagonoma and _________ can cause seconday diabetes
pancreatitis, pregnancy
Complications of poorly controlled diabetics include kidney, cardiovascular, eye hemorrhages and nervous system problems. T/F
True; True
________ necrosis / polynephritis is often a result of diabetes.
Papillary
Cariovascular problems caused by diabetes include atherosclerosis, peripheral vascular insufficiency (gangrene) and more commonly _____.
MI's
Amyloidosis is common in type __ diabetes; and fibrosis is common in type ___.
II, I
t/f it is more common to see a hypoglycemic diabetic patient than hyperglycemic?
true (according to dr hess)
How can you assess if a patient is well controlled diabetic?
acts them what their Hba1c is (yes, "acts" was written for you coles)
Normal fasting glucose level is _____ mg/dl
60-100
A glucose level of ______ is considered elevated and _______ severely elevated.
180-240, >250
Define HbA1c?
% of glycosylated hemoglobin
What are the normal values of HbA1c?
normal is below 6.5%
Elevated A1c is ______ and severley elevated is ______
8.5-10%, and 10.5-14%
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.
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
The kidney basement membrane becomes thicker and less permeable with poorly controlled diabetes. T/F
false ; becomes thicker, but more permeable -->nephrotic syndrome
_____________ disease (diffuse glomerulosclerosis) is common in people with long standing diabetes and affects the ________ (which organ of the body)
Kimmelsteil wilson, kidney
Which of the following is not an anatomic change in diabetic patients: cataracts, peripheral neuropathy, fatty change in liver, xanthoma, abcesses/fungal lesions, gangrene.
all are symptoms
Which is not a symptom of hyperglycemia: thirst, polyurea, hunger, blurred vision, sweating, nausea and drowsyness.
sweating is a sign of hypo-glycemia
Which is not a symptom of hypoglycemia: sweating, anxiety, tremors, nausea, confusion and headache.
all are symptoms