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Test 3
Pancreas pathology
36
Pathology
Undergraduate 3
11/15/2011

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Term
Pancreas
Definition

hidden away, tucked adjacent to the duodenum and spleen.

has two organs in one

Term
Exocrine pancreas
Definition

secretes digestive enzymes into the duodenum via the Ampulla of Vater

digestive enzymes: amylase, lipase, and peptidases

Term
Amylase
Definition
digestion of starch
Term
Lipase
Definition
digestion of lipids
Term
peptidases
Definition
digestion of proteins 
Term
Endocrine pancreas
Definition

produces insulin, glucagons and somatostatin, directly into the blood

called the Islets of Langerhans

three cell types can be identified with special stains: Alpha, Beta, and Delta cells

Term
Islets of langerhans
Definition
the endocrine portion of the pancreas
Term
Alpha cells
Definition
produce glucagon
Term
Beta cells
Definition
secrete insulin
Term
Delta cells
Definition
secrete somatostatin
Term
Pancreaitis
Definition

inflammation of the pancreas. Severe pain that radiates to the back

three types: Acute edematous, Acute hemorrhagic pancreatitis, and Chronic pancreatitis 

Term
Acute Pancreatits
Definition

caused by the release of pancreatic enzymes upon itself

associated with alcohol, obstruction of pancreatic duct, high fat diets and idiopathic

Term
Acute hemorrhagic pancreatitis
Definition

can lead to shock and death (20%)

complications include pseudocyst formation, abscess formation and lead to chronic pancreatitis which can also lead to endocrine insufficiency 

Term
Chronic Pancreatitis
Definition
characterized by fibrosis and can result in both exocrine and endocrine insufficiency 
Term
Adenocarcinomas from exocrine ducts
Definition

risk factors include smoking, high fat diet and alcohol abuse 

a disease of old age that is present late and difficult to treat

if found small, can do Whipple operation and remove pancreas

CT scans have made diagnosis possible at earlier time

Term
tumor of endocrine pancreas
Definition

originate from cells in the Islets of Langerhans and are rare

produce biologically active substances

most common are insulinomas but there are glucagonomas and somatostatinomas

Term
insulinomas
Definition
tumor producing insulin and derived from B cells
Term
Diabetes mellitus
Definition

caused by functional insufficiency of Beta cells

characterized by hyperglycemia, glucose in urine, production of ketone bodies and damage to vessels resulting in decreased vision and diseases of peripheral nerves and glomerular disease of the kidney 

 

Term
diabetes mellitus
Definition
symptoms caused by absolute or relative insulin deficiency or an abnormal response of target tissues
Term
Primary diabetes mellitus
Definition
Type 1 and Type 2, under 30, sudden onset, normal body built, loss of beta cells and treatment is insulin
Term
Type 1 DM
Definition

due to absolute lack of insulin and can occur at any age.

associated with an autoimmune process where lymphocytes target and destroy the B cells

usually triggered by a viral infection

insulin dependent

Term
Type 2 DM
Definition

not enough insulin either because there is resistance to its ability for glucose to enter cells or because the demands of the body (obese) are greater than the amount of insulin produced

non-insulin dependent

Term
Secondary DM
Definition

diseases of pancreas, endocrine disorders, drugs, insulin receptor deficiencies 

over 30, gradual, obesity, beta cells present

treatment is diet oral hypoglycemics and insulin

Term
Diet oral hypoglycemics and insulin
Definition
treatment of secondary DM
Term
gestational and impaired glucose tolerance
Definition
special forms of DM
Term
diabetes
Definition
has a genetic predisposition which is stronger for type 2 than type 1. the disease is likely to be polygenic and environmental factors are very important 
Term
Cardiovascular complications of DM
Definition

increased atherosclerosis with coronary artery disease

atherosclerosis of aorta with anerurysms

diseased arteries of lower extremities with ulcers and gangrene

Term
Glomeruloscerosis
Definition

renal complication from DM

amorphous glycosalated masses trapped in the kidney glomeruli as well as small vessel damage

Term
Microangiopaty
Definition

of retinal vessels which lead to blindness and cataracts

of vessels of nerves

Term
A1-C hemoglobin
Definition
measure for DM patients to determine how well the patient is being regulated because the better the control of glucose levels the less complications occur
Term
Polydipsia
Definition
excessive thirst
Term
Polyphagia 
Definition
excessive intake of carbohydrates
Term
Ketoacidosis
Definition
breaking down fat to produce energy
Term
Untreated DM patient
Definition
start out with polydipsia and polyphagia and if untreated can develop life threatening ketoacidosis
Term
Treatment of DM
Definition

tight control of blood glucose with using insulin pumps to adjust insulin levels.

 

Term
Glycosalated
Definition
When blood glucose becomes elevated it becomes this and sticks to the basement membranes around small and large vessels producing ischemia like disease
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