Gastro - Exocrine Pancreas Flashcards Preview

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Flashcards in Gastro - Exocrine Pancreas Deck (64)
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1

What are the functions of the pancreas?

Secretes digestive enzymes, bicarbonate, and colipase

Antibacterial functions

Promotes SI function

Protects against autodigestion (both local and systemic inhibitors)

2

What pancreatic cells primarily control the exocrine function of the pancreas?

acinar cells

3

How does the pancreas defend against autodigestion?

Synthesis of inactive zymogens

Storage in the rough ER

Production of trypsin inhibitor (PSTi)

Plasma protease inhibitors (alpha-macroglobulins)

 

What he wants us to recognize is that there is a local and systemic inhibitor

4

What is exocrine pancreatic insufficiency (EPI)?

insufficient secretion of digestive enzymes

5

Is EPI more common in dogs or cats?

dogs

6

What disease processes can cause EPI?

Pancreatic acinar atrophy (PAA) - most common in young dogs

Chronic pancreatitis - in cats

Pancreatic neoplasia - adenocarcinoma

7

What imbalances is EPI associated with?

microbial imbalances with hypocobalaminemia

8

What history and signs is associated with EPI?

Weight loss but good appetite, small bowel diarrhea, flatulence, borborygmus, poor hair coat, coprophagia, and cats may have a reduced appetite

9

If a patient has both EPI and diabetes mellitus what clinical sign might it have?

PU/PD

10

What is coprophagia?

eating feces

11

How is EPI diagnosed?

based on clinical signs, hypocobalaminemia, TLI assay, and Cobalamin assay

12

What is the test of choice for diagnosing EPI?

TLI assay - species specific

13

What will the results of a TLI assay show if a dog has EPI?

The TLI levels will be subnormal levels

14

How is EPI treated?

highly digestible diets, oral pancreatic enzyme supplements, vitamine/mineral supplements, and/or high quality maintenance diet

15

What is given as treatment for ARD in non-responsive patients?

tylosin

16

When should EPI patients respond to therapy?

within 3-5 days

17

Once patients begin responding to EPI therapy, what should be done with the enzyme dosages?

You should gradually decrease the dose of enzymes

18

If there is no response to EPI therapy, what next step should be considered?

Dysbiosis - use tylosin

19

What is the prognosis of EPI?

good

20

True or False: Once EPI is treated initially, you do not need to continue to treat.

False - it requires life-long therapy

21

Is there permanent damage associated with acute pancreatitis?

There is rarely permanent damage

22

What are the two forms of acute pancreatitis?

edematous and necrotizing form

23

Is there permanent damage associated with chronic pancreatitis?

yes, it is associated with irreversible damage with fibrosis

24

What are the risk factors associated with pancreatitis?

Dietary indiscretion (high fat), pancreatic ischemia, hypercalcemia, disturbances in lipid metabolism, hepatobiliary disease, drugs, and some breed predispositions

25

What disease processes can cause disturbances in lipid metabolism?

Cushings and Diabetes mellitus

26

What species typically gets hepatobiliary disease?

cats

27

What drugs can lead to pancreatitis?

Phenobarbital and azathioprine

28

True or False: The underlying cause of pancreatitis is often known.

false - it is often unknown

29

What are the mechanisms of injury to the pancreas?

Premature activation of zymogens, reactive oxygen metabolites cause direct cellular damage, and depletion of protease inhibitors

30

A.

trypsin

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