pancreas CUdental revised
Terms
undefined, object
copy deck
- 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