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Pancreatic Function and Enzymes
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Pancreatic Function and Enzymes
Pancreatic Function and Enzymes
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1
Question
What are the two major functional divisions of the pancreas?
Page 3
Answer
The pancreas has endocrine and exocrine functions. Endocrine tissue releases hormones, whereas exocrine tissue produces digestive secretions.
2
Question
Which pancreatic cell produces insulin, and what does insulin regulate?
Page 3
Answer
The beta cell of the islets of Langerhans produces insulin. The pancreatic material identifies insulin as a principal endocrine hormone of the beta cell.
3
Question
Which pancreatic cell produces glucagon?
Page 3
Answer
The alpha cell of the islets of Langerhans produces glucagon.
4
Question
Which pancreatic cell produces somatostatin?
Page 3
Answer
The delta cell of the islets of Langerhans produces somatostatin.
5
Question
How does pancreatic juice participate in digestion?
Page 3
Answer
Pancreatic juice is released into the duodenum, where it mixes with partially digested food. Its enzymes are essential for protein, carbohydrate, and lipid digestion.
6
Question
Why is pancreatic juice described as an alkaline fluid?
Page 3
Answer
It is described as an alkaline fluid that enters the duodenum with digestive enzymes. The alkaline character is presented as a defining feature of pancreatic juice.
7
Question
Which stimuli mainly induce pancreatic exocrine secretion?
Page 3
Answer
Pancreatic secretion can respond to nervous stimuli, but it is induced mainly by the hormones secretin and cholecystokinin-pancreozymin (CCK-PZ).
8
Question
Which noninvasive serum tests assess pancreatic function?
Page 4
Answer
Serum amylase and serum lipase are noninvasive blood tests used in pancreatic function assessment.
9
Question
Which stool tests are listed for pancreatic assessment?
Page 4
Answer
The listed stool tests are fecal fat, fecal trypsin and chymotrypsin, and fecal elastase.
10
Question
How can sweat be used in the laboratory assessment of cystic fibrosis?
Page 4
Answer
Sweat sodium and chloride are measured. Increased sweat sodium and chloride are associated with cystic fibrosis.
11
Question
What makes direct duodenal intubation an invasive pancreatic test?
Page 4
Answer
It directly samples fasting duodenal contents and contents obtained after stimulation with secretin and cholecystokinin. The procedure therefore requires instrumentation of the duodenum.
12
Question
What type of enzyme is amylase?
Page 5
Answer
Amylase is a hydrolase. It splits complex carbohydrates composed of alpha-D-glucose units, including starch and glycogen.
13
Question
Which two tissues provide most serum amylase?
Page 5
Answer
Most serum amylase arises from the pancreas as P-isoamylase and from the salivary glands as S-isoamylase.
14
Question
What are the principal tissue origins of amylase in normal serum and urine?
Page 6
Answer
Amylase in normal serum and urine is predominantly of pancreatic origin, called P-AMY, and salivary-gland origin, called S-AMY.
15
Question
Which additional tissues contain measurable amylase activity?
Page 6
Answer
Amylase activity is also found in extracts from the ovaries, Fallopian tubes, lungs, and adipose tissue.
16
Question
Why can some lung and ovarian tumors increase amylase activity?
Page 6
Answer
Some lung and ovarian tumors may contain considerable amylase activity, usually of the S-type. Tumor-associated activity can therefore contribute to increased measurements.
17
Question
Why may ascitic and pleural fluids contain amylase?
Page 6
Answer
Ascitic and pleural fluids may contain amylase when a tumor or pancreatitis is present.
18
Question
Which laboratory methods can measure amylase isoenzymes?
Page 7
Answer
Methods include electrophoresis, ion-exchange chromatography, isoelectric focusing, selective inhibition of S-AMY by immunoprecipitation with a monoclonal antibody, and immunoinhibition.
19
Question
How does selective immunoinhibition help distinguish amylase isoenzymes?
Page 7
Answer
A monoclonal antibody is used to selectively inhibit S-AMY. The remaining activity can therefore be used to assess the pancreatic component.
20
Question
How long is amylase stable at room temperature?
Page 7
Answer
Amylase is stable for 4 days at room temperature.
21
Question
How long can amylase be stored at −4 °C?
Page 7
Answer
Amylase is stable for 2 weeks at −4 °C.
22
Question
How long can amylase be stored at −25 °C?
Page 7
Answer
Amylase is stable for 1 year at −25 °C.
23
Question
How long can amylase be stored at −75 °C?
Page 7
Answer
Amylase is stable for 5 years at −75 °C.
24
Question
Which conditions markedly increase amylase activity?
Page 8
Answer
Amylase activity is greatly increased in acute pancreatitis and in salivary-gland inflammation.
25
Question
Why does a higher amylase rise increase the probability of acute pancreatitis?
Page 8
Answer
The magnitude of amylase elevation is not related to the severity of pancreatic involvement. However, a greater rise increases the probability that acute pancreatitis is present.
26
Question
Which pancreatic diseases can cause hyperamylasemia?
Page 9
Answer
Pancreatitis of any cause and pancreatic trauma can produce increased pancreatic amylase activity, or P-AMY.
27
Question
Which intra-abdominal diseases can cause increased P-AMY?
Page 9
Answer
Biliary tract disease, intestinal obstruction, mesenteric infarction, perforated peptic ulcer, gastritis, duodenitis, ruptured aortic aneurysm, perforated acute appendicitis, peritonitis, and trauma are listed causes.
28
Question
Which genitourinary conditions can cause hyperamylasemia?
Page 9
Answer
Ectopic or ruptured tubal pregnancy, salpingitis, ovarian malignancy, and renal insufficiency are listed. Salpingitis and ovarian malignancy are associated with S-AMY, whereas renal insufficiency produces mixed activity.
29
Question
Which miscellaneous conditions can increase serum amylase?
Page 9
Answer
Listed causes include salivary-gland lesions, acute alcoholic abuse, diabetic ketoacidosis, macroamylasemia, septic shock, cardiac surgery, tumors, and drugs.
30
Question
What reaction does pancreatic lipase catalyze?
Page 10
Answer
Lipases hydrolyze glycerol esters of long-chain fatty acids in emulsified form.