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09 Exocrine-Endocrine Functions of the Pancreas + Fecalysis
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ack-four-fanta-sad-friend-uranus
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Published
07/30/2024
Pancreas{{c1::Exocrine}} pancreas80-85% of the pancreas{{c2::Acinar cells}}: produce enzymes for food digestion
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07/30/2024
PancreasExocrine Pancreas{{c1::Amylase}}Responsible for breakdown of ingested {{c2::complex carbohydrates}} producing monosaccharides
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07/30/2024
PancreasExocrine PancreasProteolytic Enzymes: {{c1::trypsin, chymotrypsin, carboxypeptidase, elastase}}Lipolytic enzymes: {{c1::lipase, phospholipase,…
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07/30/2024
Pancreas{{c1::Endocrine Pancreas}}{{c2::Islets of Langerhans}}: secrete hormones that are essential for metabolism
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07/30/2024
PancreasEndocrine PancreasHormones{{c1::Insulin, Glucagon, Somatostatin, Pancreatic Polypeptide}}
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07/30/2024
PancreasEndocrine PancreasHormones and LocationsAlpha islet: {{c1::Glucagon::Hormone}}Beta islet: {{c1::Insulin::Hormone}}Delta islet: SomatostatinPP …
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07/30/2024
PancreasEndocrine PancreasHormones and LocationsAlpha islet: GlucagonBeta islet: InsulinDelta islet: {{c1::Somatostatin::Hormone}}PP or F Islet: {{c1:…
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07/30/2024
PancreasEndocrine Pancreas{{c1::Insulin}}Anabolic hormone from the beta cells for glucose uptake in insulin-sensitive tissuesTissues: {{c2::skeletal m…
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07/30/2024
PancreasEndocrine PancreasInsulin{{c1::Inhibits::Enhances/Inhibits}} glucose production{{c1::Increase::Increase/Decrease}} protein and triglyceride sy…
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07/30/2024
PancreasEndocrine PancreasInsulinStructure: 21 AA {{c1::alpha::alpha/beta}} chains + 30 AA {{c1::beta::alpha/beta}} chains linked by 2 {{c1::disulfide…
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07/30/2024
PancreasEndocrine PancreasInsulinDeficiency: {{c1::Diabetes Mellitus}}Excess due to:{{c1::Inappropriate secretion or administrationInsulin resistanceI…
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07/30/2024
PancreasEndocrine Pancreas{{c1::Preproinsulin}}Single-chain peptide precursor further metabolized to form proinsulin
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07/30/2024
PancreasEndocrine Pancreas{{c1::Proinsulin}}Immediate precursor of insulinConvered into insulin through the removal of the {{c2::C-peptide::protein}} …
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07/30/2024
PancreasEndocrine PancreasProinsulinHigher in {{c1::healthy infants and preterm neonates::patient age populations}}
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07/30/2024
PancreasEndocrine Pancreas{{c1::C-Peptide}}31 AA peptide segment connecting the alpha and beta chainsRemoved to convert proinsulin to insulin
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07/30/2024
PancreasEndocrine PancreasC-PeptideC-peptide:Insulin concentration ratioPortal vein: {{c1::1:1}}Serum: {{c1::5:1 (fasting) to 15:1 (hepatic clearance)…
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07/30/2024
PancreasEndocrine PancreasC-PeptideClearance: {{c1::negligible}}
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07/30/2024
PancreasEndocrine Pancreas{{c1::Amylin or Islet Amyloid Polypeptide}}Co-localized and co-secreted with insulin in response to stimulation by nutrients
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07/30/2024
PancreasEndocrine PancreasAmylin or Islet Amyloid Polypeptide{{c1::Slows::Slows/Enhances}} gastric emptying time{{c1::Inhibits::Inhibits/Enhances}} po…
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07/30/2024
PancreasEndocrine PancreasGlucagonSynthesized by:{{c1::Alpha cellsL cells}}
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07/30/2024
PancreasEndocrine PancreasGlucagonRegulates: {{c1::hepatic glycogenolysis, gluconeogenesis, ketogenesis, hepatic amino acid turnover}}
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07/30/2024
PancreasEndocrine Pancreas{{c1::Glucagon}}{{c2::Increases::Increases/Decreases}} glucose production
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07/30/2024
PancreasEndocrine PancreasGlucagonNormal Fasting Plasma Conc: {{c1::25-50 pg/mL}}
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07/30/2024
PancreasEndocrine Pancreas{{c1::Glucagonoma}}Glucagon releasing tumorsFasting glucose levels: {{c2::>120 pg/mL}}
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07/30/2024
PancreasEndocrine PancreasGlucagonomaClinical Manifestations{{c1::Necrotizing migratory erythematous rash, Stomatitis, Glossitis, Weight loss, Anemia,…
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07/30/2024
PancreasEndocrine Pancreas{{c1::Somatostatin}}Originally discovered as a hypothalamic hormone that {{c2::inhibits::enhances/inhibits}} growth hormone …
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07/30/2024
PancreasEndocrine PancreasSomatostatin{{c1::Inhibits::Enhances/Inhibits}} the secretion of insulin and glucagonNon-endocrine functions:{{c1::Inhibitio…
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07/30/2024
PancreasEndocrine Pancreas{{c1::Incretin}}Greater and earlier insulin response
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07/30/2024
PancreasEndocrine PancreasIncretinOral glucose {{c1::>::>/</=}} IV glucose
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07/30/2024
PancreasEndocrine PancreasIncretinMost important incretins: {{c1::GLP-1 and Gastric Inhibitory Polypeptide}}
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07/30/2024
PancreasEndocrine PancreasGLP-1 and GIP Effects{{c1::Stimulates::stimulates/inhibits}} insulin and SST secretion{{c1::Suppresses::stimulates/suppresse…
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07/30/2024
PancreasEndocrine PancreasGhrelinIn the pancreas{{c1::Inhibits::Stimulates/Inhibits}} glucose-stimulated insulin secretion{{c1::Stimulates::Stimulates…
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07/30/2024
PancreasEndocrine Pancreas{{c2::Pancreatic Polypeptide}}{{c1::Increases::Increase/Decrease}} satiety{{c1::Delays::Enhance/Delay}} gastric emptying{{c1…
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07/30/2024
PancreasGlucose MeasurementStandard specimen: {{c1::plasma or serum}}Fasting requirement: {{c1::8-14 hours}}Color of tube: {{c1::Gray}}
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07/30/2024
PancreasGlucose MeasurementPOCTSpecimen: {{c1::Whole blood}}Parameter monitored: {{c1::CBG}}
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07/30/2024
PancreasGlucose MeasurementPOCT10-15% {{c1::lower::higher/lower}} than plasma glucoseAffected by {{c1::food ingestion}}
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07/30/2024
PancreasGlucose MeasurementPOCTT/F This is used to diagnose DM {{c1::False}}
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07/30/2024
PancreasGlucose MeasurementPOCTConfirm results with {{c1::plasma}} specimen
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07/30/2024
PancreasGlucose MeasurementEnzymatic Method{{c1::Hexokinase}}Reference method for glucose determination
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07/30/2024
PancreasGlucose MeasurementEnzymatic Method: HexokinaseGlucose via hexokinase -> {{c1::G6P}} via G6PDH --> {{c1::NADPH}}Absorbance of NADPH at 3…
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07/30/2024
PancreasGlucose MeasurementEnzymatic Method{{c1::Glucose oxidase}}Two-step method
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07/30/2024
PancreasGlucose MeasurementEnzymatic Method: Glucose oxidaseOxidation of glucose forms {{c1::hydrogen peroxide}} which reacts with parahydroxybenzoic …
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07/30/2024
PancreasScreening of DMCriteria for Diabetes/PrediabetesFamiliarize {{c1::me}}
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PancreasScreening of DMCriteria for Diabetes/PrediabetesFamiliarize {{c1::me}}
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07/30/2024
PancreasDiagnosis of DMT/FTests can be performed on two different days or two differenttests can be performed on the same day{{c1::True}}
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07/30/2024
PancreasDiagnosis of DMThere should be {{c1::2}} abnormal test results
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PancreasDiagnosis of DMMemorize {{c1::me}}
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PancreasDiagnosis of DMPatient PreparationFasting Plasma Glucose: no caloric intake for at least {{c1::8 hrs}}2 hr plasma glucoseAdults: {{c2::75g}} g…
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07/30/2024
PancreasDiagnosis of DM{{c1::Gestational DM}}75g OGTT at {{c2::24-28 weeks AOG::AOG}} for women not previously diagnosed with overt DM
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07/30/2024
PancreasDiagnosis of DMGestational DMOGTT should be performed in the morning after an overnight fast of at least {{c1::8 hrs}}
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07/30/2024
PancreasDiagnosis of DMGestational DMDiagnosis is made when ANY of the following are exceeded★ Fasting: {{c1::≥92 mg/dL (5.1 mmol/L)}}★ 1hr: {{c1::≥18…
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07/30/2024
PancreasDiagnosis of DMGestational DMFamiliarize {{c1::me}}
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07/30/2024
PancreasDiagnosis of DM Type 1Type 2Frequency5-10%90-95%Age of Onset{{c1::Any }}{{c1::More common in advancing age}}Risk factors {{c2:…
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PancreasDiagnosis of DM{{c2::Type 1 DM}}{{c1::Absolute insulin deficiency}}{{c1::Decreased::Decreased/Increased}} C-peptideGenetic predisposition: HLA…
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07/30/2024
PancreasDiagnosis of DMType 1 DM DxAntibody Markers for beta cell destructionPersistence of {{c1::2 or more}} autoantibodies
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PancreasDiagnosis of DM{{c2::Type 2 DM}}{{c1::Familial}} but genetic defects are yet to be determinedUsually {{c1::asymptomatic}}
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PancreasDiagnosis of DMType 2 DM ScreeningGeneral: {{c1::every 3 years }}Earlier and more frequent in {{c1::high::high/low}} risk patientsTests: …
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PancreasDiagnosis of DM{{c2::Type 2 DM }}Insulin resistant, overweight or obese{{c1::High}} hepatic glucose production and {{c1::impaired}} perip…
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PancreasDiagnosis of DM{{c1::HbA1c}}Irreversibly glycosylated at one or both N-terminal valines of beta chains of hemoglobin
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07/30/2024
PancreasDiagnosis of DMHbA1cMonitors glycemic control for the past {{c1::3-6 months}}
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07/30/2024
PancreasDiagnosis of DMHbA1cAffected by:{{c1::Blood loss, blood transfusion, hemolysis, pregnancy, EPO, uremia, hemoglobinopathy, salicylate, hemodial…
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07/30/2024
PancreasDiagnosis of DMHbA1cFormation1st Reaction:{{c1::Rapid and reversible}} that forms {{c1::aldimine}} (schiff base)2nd Reaction:{{c2::Slower Amad…
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07/30/2024
PancreasDiagnosis of DM{{c1::1,5-Anhydroglucitol or Glycomark}}Reflects {{c2::glycemic excursion, postprandial glycemia and short term hyperglycemia}}
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07/30/2024
PancreasDiagnosis of DM1,5-Anhydroglucitol or Glycomark{{c1::Glycemic excursion}}: fluctuation in the blood glucose in the past {{c2::24 hrs}}
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07/30/2024
PancreasDiagnosis of DM1,5-Anhydroglucitol or GlycomarkDecreased in {{c1::hyperglycemia}}
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07/30/2024
PancreasDiagnosis of DM1,5-Anhydroglucitol or GlycomarkNormally {{c1::99%}} reabsorbed in the renal tubules
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07/30/2024
PancreasDiagnosis of DM{{c1::Fructosamine Assay}}Primarily measures {{c2::glycosylated albumin}}
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07/30/2024
PancreasDiagnosis of DM{{c1::Glycated Albumin Assay}}Reported as percent of {{c2::total albumin}}
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07/30/2024
PancreasDiabetic KetoacidosisRate when ketone formation {{c1::>::>/</=}} peripheral tissue utilizationResults in {{c1::ketonemia and ketonuri…
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07/30/2024
PancreasDiabetic KetoacidosisInsulin deficiency → {{c1::INC::INC/DEC}} lipase activity → breakdown of adipose and {{c1::INC::INC/DEC}} FFA →…
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07/30/2024
PancreasDiabetic KetoacidosisT/F This is considered a medical emergency{{c1::True}}
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07/30/2024
PancreasDiabetic KetoacidosisSymptoms{{c1::NauseaVomitingVague abdominal painElectrolyte disturbanceDehydration}}
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07/30/2024
PancreasDiabetic KetoacidosisKetone ratioB-hydroxybutyric acid:Acetoacetic acid = {{c1::1:1 normal ratio}}In DKA: {{c1::INC::INC/DEC}} ratio
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07/30/2024
PancreasDiabetic Ketoacidosis Testing{{c1::Rothera's Test}}Reaction with {{c2::alkaline sodium nitroprusside}}
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PancreasDiabetic Ketoacidosis Testing{{c2::Strips}}Contains {{c1::sodium nitroprusside}}Color change: {{c1::purple}}
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07/30/2024
PancreasDiabetic Ketoacidosis TestingAdd {{c1::glycine}} to detect acetone
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Pancreas{{c1::Hypoglycemia}}Plasma glucose: {{c2::≤55 mg/dL}}
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07/30/2024
PancreasHypoglycemiaRate of glucose utilization {{c1::>::>/</=}} Rate of glucose production
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PancreasHypoglycemiaWhipple's Triad{{c1::Low plasma glucoseSymptoms of hypoglycemiaRelief of symptoms when corrected}}
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PancreasHypoglycemiaFamiliarize {{c1::me}}
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PancreasHypoglycemia Causes{{c1::Drug-inducedAlcohol intakeSevere medical illnessInsulinomaNon-Beta cell tumor}}
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PancreasHypoglycemiaDrug-inducedDue to: {{c1::insulin and secretagogues}}Clue: {{c1::High insulin and C-peptide levels}} with positive drug screen
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PancreasHypoglycemiaAlcohol{{c1::Inhibit::Stimulate/Inhibit}} hepatic gluconeogenesis{{c1::Increase::Increase/Decrease}} glycogen phosphorylase
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07/30/2024
PancreasHypoglycemiaSevere medical illnessFamiliarize {{c1::me}}
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07/30/2024
PancreasHypoglycemiaInsulinomaFamiliarize {{c1::me}}
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07/30/2024
PancreasHypoglycemiaDiseaseC-PeptideInsulinInsulinoma{{c1::INC}}{{c1::INC}}Exogenous Insulin{{c2::DEC}}{{c2::INC}}Type 1 DM{{c3::DEC}}{{c3::DEC}}
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07/30/2024
PancreasExocrine{{c1::Cystic fibrosis}}Autosomal-recessive disease involving mutations in {{c2::CFTR gene}} on chromosome 7 encoding for {{c2::epithel…
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07/30/2024
PancreasExocrine{{c1::Cystic Fibrosis}}Abnormally viscous mucous secretions from various exocrine glands leading to chronic lung disease and malabsorp…
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07/30/2024
PancreasExocrineCystic FibrosisInitial test: {{c1::Sweat chloride test of >60 mmol/L at least 2 occasions}}Confirmatory{{c1::Administration of…
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07/30/2024
PancreasExocrineCystic FibrosisSweat Chlorideaka {{c2::Gibson-Cooke method}}Patient induced to sweat by giving {{c1::pilocarpine }}
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07/30/2024
PancreasExocrine{{c1::Acute Pancreatitis}}Acute reversible inflammation due to necrosis of pancreatic tissue by proteolytic digestive enzymes
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07/30/2024
PancreasExocrineAcute PancreatitisFeatures{{c1::NauseaVomitingElevated amylase and/or lipase}}
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07/30/2024
PancreasExocrineAcute PancreatitisFamiliarize {{c1::me}}
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07/30/2024
PancreasExocrine Pancreas Lab TestsAmylase{{c1::Not specific::specific/not specific}} testTube: {{c1::red or green}}Avoid: {{c1::citrate or oxalate}}
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07/30/2024
PancreasExocrine Pancreas Lab TestsAmylaseT/FMay be normal in hyperlipidemic patients{{c1::True}}
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07/30/2024
PancreasExocrine Pancreas Lab TestsAmylaseIncreases in {{c1::2-12 hours}}Peak: {{c1::12-72 hrs}}Duration: {{c1::14 days}}
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07/30/2024
PancreasExocrine Pancreas Lab TestsAmylaseProlonged elevation: {{c1::pancreatic necrosis or pancreatic pseudocyst}}
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07/30/2024
PancreasExocrine Pancreas Lab Tests{{c2::Lipase}}Major source: {{c1::pancreas}}{{c1::More::More/Less}} specific for acute pancreatitisHydrolyzes {{c1:…
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07/30/2024
PancreasExocrine Pancreas Lab TestsLipaseIncrease in {{c1::4-8 hrs}}Peak: {{c1::24 hrs}}Duration: {{c1::8-14 days but remains elevated longer than amy…
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07/30/2024
PancreasExocrine Pancreas Lab TestsRanson's CriteriaAt OnsetAt 48 hrsAge{{c1::>55}}HCTFall by {{c2::≥10%}}WBC count{{c1::>16,000/mm3}}BUNIncreas…
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07/30/2024
Pancreas Exocrine Pancreas Lab Tests Ranson's Criteria Severe pancreatitis likely: {{c1::≥ 3}}Severe pancreatitis unlikely: {{c1::< 3}}
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07/30/2024
PancreasExocrine Pancreas Lab TestsRanson's Criteria pertaining to Mortality0-2: {{c1::2% mortality}}3-4: {{c1::15% mortality}}5-6: {{c1::40% mortalit…
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07/30/2024
PancreasExocrine Pancreas Lab TestsBISAP ScoringParameters: {{c1::BUN, Impaired Mental Status, SIRS, Age, Pleural Effusion}}
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07/30/2024
PancreasExocrine Pancreas Lab TestsBISAP ScoringParameter01BUN{{c1::< 25 mg/dL}}{{c2::> 25 mg/dL}}Impaired Mental Status{{c1::Absent}}{{c2::Pres…
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07/30/2024
PancreasExocrine Pancreas Lab TestsBISAP Scoring0-2: {{c1::lower::lower/higher}} mortality3-5: {{c1::higher::lower/higher}} mortality
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PancreasExocrine Pancreas Lab Tests{{c1::Chronic Pancreatitis}}Irreversible damage and often progressive inflammation with irregular fibrosis, duct du…
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07/30/2024
PancreasExocrine Pancreas Lab TestsChronic PancreatitisFamiliarize {{c1::me}}
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07/30/2024
PancreasExocrine Pancreas Lab TestsFunctional Tests{{c1::SteatorrheaSerum trypsinogen (NV: <20 ng/mL)Low fecal elastase}}
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PancreasExocrine Pancreas Lab Tests{{c1::Macroamylasemia}}Acquired benign condition characterized by {{c2::increased}} serum amylase {{c2::without::wi…
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PancreasExocrine Pancreas Lab Tests{{c1::Macroamylase}}Cannot be filtered by glomerulus due to it creating a complex with {{c2::IgG, IgA or polysaccha…
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07/30/2024
PancreasExocrine Pancreas Lab Tests{{c2::Carcinoid Tumors}}Neuroendocrine tumor of {{c1::enterochromaffin cells}}Carcinoid tumors: release {{c1::serot…
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07/30/2024
PancreasExocrine Pancreas Lab TestsCarcinoid TumorsTests{{c1::Colorimetry, Fluorescence polarization immunoassay, Fluorometry, HPLC, Gas chromatograph…
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PancreasExocrine Pancreas Lab TestsCarcinoid TumorsTests5-HIAA in 24 hr urineNV: {{c1::2-8 mg/24hr}}
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07/30/2024
FecalysisSpecimenRandom: {{c1::plastic or glass with screw-tops for qualitative testing and microscopic exam}}Timed: {{c1::3 day collection for quanti…
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07/30/2024
FecalysisMacroscopic Examination{{c1::Quantity, Form, Consistency, Color}}
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07/30/2024
FecalysisMacroscopic ExaminationQuantityNormal: {{c1::100-200 g/day}}Diarrheic: {{c1::watery}}Steatorrhea: {{c1::mushy, foul-smelling, gray, floats}}C…
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07/30/2024
FecalysisMacroscopic ExaminationColorClay: {{c1::diminution or absence of bile or presence of barium sulfate}}Bloody: {{c1::Lower GI bleeding}}Black: …
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07/30/2024
FecalysisMacroscopic Examination{{c1::Mucus}}Translucent gelatinous mucus clinign to the surface of formed stool
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FecalysisMacroscopic ExaminationMucus{{c1::Bloody mucus}} cling to the fecal mass{{c2::Seen in neoplasms, inflammation of rectum}}
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FecalysisMacroscopic ExaminationMucusPus and blood presents in:{{c1::ulcerative colitis, dysentery, ulcerating diverticulitis, pseudomembranous coliti…
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07/30/2024
FecalysisMacroscopic ExaminationPusSecondary to{{c1::Chronic ulcerative colitis, infectious proctitis, chronic dysentery}}Confirmation: {{c1::microsco…
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07/30/2024
FecalysisMicroscopic Examination{{c1::WBCs}}Preliminary test to determine if diarrhea is due to invasive bacterial pathogens or toxin productionStain:…
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07/30/2024
FecalysisMicroscopic ExaminationWBCsDiff count for significant levels: {{c1::at least 3 neutrophils per hpf}}
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07/30/2024
FecalysisMicroscopic Examination{{c1::Fat}}Screen for {{c2::steatorrhea}} and monitor {{c2::malabsorption}}Stain: {{c2::Sudan III, IV and Oil red O}}
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FecalysisMicroscopic Examination{{c1::Neutral Fat}}Large {{c2::orange or red}} droplets
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FecalysisMicroscopic ExaminationNeutral Fats{{c1::Mineral or castor oil}} must be ruled out Significant: {{c1::≥60 stained droplets (<4μm…
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FecalysisMicroscopic Examination{{c1::Soap and Fatty Acid}}Not directly stained by {{c2::Sudan III}}Normal: {{c2::100 small droplets (<4um in diame…
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07/30/2024
FecalysisMicroscopic ExaminationMeat FiberMaldigestion and/or hypermotility: {{c1::>10 fibers/hpf}}
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07/30/2024
FecalysisChemical ExaminationGI BleedNormal: {{c1::0.5-1.5 mL blood/day}}Associated with {{c1::normal shedding of epithelium}}{{c2::Occult}}: no visib…
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07/30/2024
FecalysisChemical ExaminationFOBTPrinciple: oxidation of {{c1::guaiac}} by {{c1::pseudoperoxidase }}
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07/30/2024
FecalysisChemical ExaminationFOBTFalse positive: {{c1::Mgb, Hgb, bacterial contamination, vegetables and fruits, NSAIDs, colchicine, reserpine}}False …
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07/30/2024
FecalysisChemical Examination{{c2::Immunochemical FOBT}}More sensitive with fewer false negativesPrinciple: {{c1::antigen-antibody reaction}}Screen: {…
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07/30/2024
FecalysisDiarrheaNormal volume of stool: {{c1::100-150mL}}
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07/30/2024
FecalysisDiarrheaFrom {{c1::INC::INC/DEC}} fluid secretion, {{c1::DEC::INC/DEC}} fluid absorption or {{c1::INC::INC/DEC}} intestinal motility
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07/30/2024
Fecalysis{{c1::Diarrhea}}Passage of {{c2::≥3 loose or liquid}} stools per day
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FecalysisDiarrhea{{c1::Osmotic}}From unasborbable or poorly absorbed solutes which alter the osmotic gradient
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07/30/2024
FecalysisDiarrheaFecal osmotic gap: {{c1::290-2 x (Fecal sodium + Fecal potassium)}}
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07/30/2024
FecalysisDiarrheaOsmotic gap >125 mOsm/kg = {{c1::Osmotic}} diarrheaOsmotic gap <50 mOsm/kg = {{c1::Secretory}} diarrhea
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07/30/2024
FecalysisDiarrhea{{c1::Secretory}}{{c2::INC::INC/DEC}} secretion of water and electrolytes into the GIT lumen
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FecalysisDiarrheaDoes {{c1::not::not or does}} stop after fasting within 24 hrs
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FecalysisDiarrheaOsmotic{{c1::Fasting or cessation of consuming the suspected solute}} for 24 hrs stops
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07/30/2024
FecalysisDiarrhea{{c2::Inflammatory}}{{c1::Immune-mediated}} injury to the GIT mucosa
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07/30/2024
FecalysisDiarrheaInflammatoryCauses:{{c1::IBD, Salmonella, Shigella, Campylobacter, EIEC, Y. enterocolitica, HIV}}
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07/30/2024
FecalysisDiarrheaSecondary to Altered Motility{{c1::INC::INC/DEC}} peristalsis {{c1::reduces::increases/reduces}} transit time down GITCauses {{c…
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FecalysisDiarrheaSecondary to Increased FiltrationDue to GI {{c1::capillary hydrostatic or oncotic pressure imbalance }}Causes: {{c2::Portal hype…
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07/30/2024
FecalysisDiarrheaIatrogenic diarrhea{{c1::Side effect}} of medication
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07/30/2024
FecalysisDiarrhea{{c2::Factitious Diarrhea}}{{c1::Self-induced}}Due to {{c1::Surreptitious laxative abuse}}
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