Pancreatic juice contains a number of enzymes, some of which are initially secreted as __________ in an inactive form

Generally speaking, disorders interfering with normal pancreatic enzyme activity cause:

Can exocrine and endocrine pancreatic dysfunction occur together in some patients?

Select the four sections of the pancreas

Which part of the pancreas is the thickest part of the gland including the ucinate process, which is the portion of the head that extends dorsally and to the left, behind the superior mesenteric vessels?

Which part of the pancreas connects the head and body and sits immediately ventral to the superior mesenteric vessels?

Which part of the pancreas is situated transversely in the retroperitoneal space, bordered superiorly by the splenic artery and dorsally by the splenic vein?

Which part of the pancreas is less fixed in the retroperitoneum and extends toward, and often immediately adjacent to the helium of the spleen?

What is the most common congenital anomaly of the pancreas?

Choose the descriptions and symptoms of pancreas divisum

Zymogen granules containing digestive enzymes are found in acinar cells. The number of zymogen granules in the cells varies- ______ are found during fasting and _____ after a meal

Is the pH of pancreatic juices acidic or basic?

Why is the pH of pancreatic juices basic?

After digestion, the remaining enzymes are secreted as ____________ proenzymes or zymogens (trypsinogen, chymotrypsinogen, proelastase, procarboxypeptidase, and phospholipase A2)

The inactive proenzymes and zymogens that are secreted after digestion are activated in the _____________.

What enzyme coverts trypsinogen to trypsin?

_________ converts all remaining proenzymes into active enzymes.

Which two hormones appear to have a primary role in the secretion of pancreatic enzymes?

What triggers the release of gastric acid?

Secretin acts chiefly on the pancreatic ductal epithelial, centroacinar, and to a lesser extent acinar cells to produce _______- thus raising the pH of pancreatic secretions

The secretion of ______ also increases in response to secretin, increasing the absolute volume of pancreatic juice

The secretion of CCK is triggered by ___________________ (peptides, amino acids, fatty acids) when they enter the duodenum

Choose the two mechanisms through which CCK controls pancreatic exocrine secretion

CCK release raises ________________ concentrations, which lead to the release of pancreatic enzymes from the zymogen granules.

The ________ action of secretin and CCK produces an abundant secretion of enzyme-rich and alkaline pancreatic juice.

Which of the following are pancreatic disorders?

Choose the characteristics of acute pancreatitis.

Which of these is a cause of acute pancreatitis?

Which of these is a cause of acute pancreatitis? cont.

The hypothesized mechanism (biliary tract disease/acute pancreatitis) is obstruction of the common bile duct and the main pancreatic duct when a _________________ becomes lodged at the ampulla of Vater

What leads to parenchymal injury?

Other mechanism (biliary tract disease/acute pancreatitis) may involve ______________________ from the gallbladder to the pancreas, giving rise to inflammation

Alcohol or its metabolite, acetaldehyde, can have a direct toxic effect on pancreatic acinar cells, leading to _______________- by the lysosomal enzymes.

__________ leading to the retention of hydrolytic enzymes in the pancreatic duct and acini

Alcohol appears to increase the precipitation of pancreatic secretions to form "_________" in the small ductules

_________ may predispose patients with alcoholism to pancreatic injury. For example, deficiencies of trace elements such as zinc or selenium occur in these patients with alcoholism and are associated with acinar cell injury.

____________, such as that associated with hyperparathyroidism, sarcoidosis, hypervitaminosis D or multiple myeloma may cause acute pancreatitis

Pathology of metabolism related acute pancreatitis

The central theory in acute pancreatitis has long centered on the aberrant activation of __________ and other enzymes within the pancreatic acini, causing autodigestion and a profound systemic inflammatory response

Recent evidence suggests that other events parallel to trypsinogen activation occur, such as the activation of ______, a protein complex that controls DNA transcription, which can induce acute pancreatitis in experimental models

If acute pancreatitis becomes recurring the gland may eventually become permanently damaged, resulting in ___________________-

Recent consensus criteria require two of the three criteria for diagnosis of acute pancreatitis. Choose the 3 criteria to be chosen from

Though a lab of serum amylase showing often to be 10-20 fold the normal amount, a ______________ may be a better diagnostic test b/c it's just as easy to perform, may be more sensitive, and is more specific for acute pancreatitis, and decreases to normal more slowly than amylase.

What may occur in severe acute pancreatitis resulting from hypovolemia from a massive exudation of plasma and hemorrhage into the retroperitoneal space?

___________ may also result from severe acute pancreatitis and can vary from mild hypoxia to respiratory failure (acute respiratory distress syndrome [ARDS])

What are pancreatic pseudocysts? (late complication of acute pancreatitis)

What is a pancreatic abscess? (late complication of acute pancreatitis)

What happens when a pancreatic ascite forms? (late complication of acute pancreatitis)

Explain the difference between acute pancreatitis and chronic pancreatitis.

What is the biggest cause of chronic pancreatitis?

Although smoking and chronic alcoholism are both independent factors for chronic pancreatitis, the combination of significant alcohol and cigarette use appears to be synergistic in augmenting the risk of chronic pancreatitis. True or false?

Can chronic pancreatitis be hereditary?

Choose the pathophysiology of chronic pancreatitis.

What is pancreatic lipase essential for?

Pancreatic insufficiency usually results from chronic pancreatitis in adults or _____________ in children.

Select potential causes of pancreatic insufficiency

Choose the clinical manifestations of pancreatic insufficiency