Gastric, Intestinal, and Pancreatic Function (PART 2)
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Compare Chohn’s and ulcerative colitis
Both: form of inflammatory bowel disease, autoimmune etiology, genetic Chron’s: can affect any portion of intestine; 10-30% test positive for ANCA test Colitis: disease of large intestine ONLY; 60-80% test positive for ANCA test
Cause of celiac disease
hypersensitivity to grains (gluten) - genetics, immune system, environment
symptoms of celiac disease
• ab bloating and pain • chronic constipation and/or diarrhea • weight loss • pale, foul-smelling stool • Flatulence (many more see slide 108)
treatment for celiac disease
remove gluten from diet
Best screening test for colon cancer
Occult Blood test
Carcinoid Syndrome - symptoms
Tumors produce serotonin which cause the symptoms of hypertension flushing, wheezing, diarrhea, right-sided valvular disease, etc.
Carcinoid Syndrome - lab diagnosis
Screen for 5-HIAA in urine
Carcinoid Syndrome - treatment
Surgical excision of the tumor(s) is the only treatment
Endocrine functions of the pancreas
• Beta cells secrete insulin • Alpha cells secrete Glucagon • Delta cells secrete Gastrin and Somatostatin
Exocrine functions of the pancreas
80% of mass made of acinar cells, grape-like clusters of cells, that produce digestive enzymes
Physiological effects of insulin
Uptake of glucose
Physiological effects of glucagon
Release of glucose from glycogen
Physiological effects of gastrin
HCL production
Consequences of secretin and CCK-PZ release on the pancreas
Secretin: made when acidic stomach contents reach duodenum; responsible for bicarb release; inhibits gastrin production in stomach CCK-PZ: made by intestinal mucosal cells; responsible for enzyme release from pancreatic acinar cells
Consequences of Vagus nerve stimulation on the pancreas
Can cause pancreatic fluid secretion during cephalic phase of digestion
Five enzymes produced by the pancreas and their substrates
• Amylase: acts on starch and carbs • Lipase: acts on trigs • Chymotrypsin: cleave peptide bonds following phenylalanine, tryptophan, and tyrosine residues • Trypsin: acts on proteins (catalyzes the hydrolysis of peptide bonds) • Elastase -1: acts on elastin
Cystic Fibrosis - cause
Autosomal recessive; most common genetic mutation is Delta F508 on long arm of chromosome 7
Cystic Fibrosis - symptoms
disrupts the function of several organs by clogging tubes
Cystic Fibrosis - clinical course
Meconium ileus at birth (bowel obstruction) • Chronic respiratory infections • Malabsorption with failure to thrive • Median survival: 30 years
Cystic Fibrosis - lab findings
Sweat Chloride Measurement >60 mEq/L on two occasions
Cancer of the head of the pancreas - symptoms and lab findings
• detected earlier than other pancreatic cancer - Jaundice, weight loss, anorexia, nausea
Cancer of the beta cell tumors - symptoms and lab findings
Cuased very low blood sugars and associated symptoms
Cancer of the alpha cell tumors - symptoms and lab findings
have a very poor prognosis; detected later because of lots of other diseases cause hyperglycemia
Acute Pancreatitis: - common causes
• Cholelithiasis (gallstones) • Excess alcohol intake • Trauma, mumps, thrombosis, drugs • Idiopathic