VI Pancreatic

VI Pancreatic - VI LABORATORY DIAGNOSISOFPANCREATIC DISEASE

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VI LABORATORY  DIAGNOSIS OF PANCREATIC  DISEASE Laboratory Medicine (SPPS 216) Robert L. Fitzgerald, Ph.D. Clinical Professor of Pathology rlfitzgerald@vapop.ucsd.edu 858-552-8585 x 7761 Wiki (ucsdlabmed.wikidot.com)
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OBJECTIVES List the functions of the pancreas Describe the structure and function of the  pancreas List complications of pancreatic disease Describe the laboratory tests used to  diagnose pancreatic disease State the functions of the various  pancreatic enzymes
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KEY TERMS  Acute Pancreatitis Amylase   Chronic Pancreatitis   Lipase  
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BACKGROUND/SIGNIFICANCE  Acute pancreatitis: 1 in 500 acute  admissions Severe attacks have a 20-50% mortality Mostly older patients, frequently  associated alcoholism, hyperlipidemia and  biliary disease   2% of acute cases are drug induced Laboratory essential for rapid diagnosis
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Anatomy of Pancreas
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Pancreatic Functions Secretes all major digestive enzymes  (lipase, amylase and trypsin) Exocrine secretion controlled by secretin  and CCK 800-3000 mL of HCO 3  rich fluid (pH 8 to  8.3) per 24 hours Endocrine functions include insulin and  glucagon
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Acute Pancreatitis  Complications Pseudocyst formation Ascites fluid Pleural effusion Abscess formation
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Pseudocyst in chronic  pancreatitis  Steer, ML, Waxman, I, Freedman, SD, N Engl J Med 1995; 332:1482.
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induced acute pancreatitis Large fluid collection replacing the head of the pancreas (arrow) with well- defined margins and no associated inflammatory changes. These features are characteristic of a pancreatic pseudocyst. Courtesy of Jonathan Kruskal, MD, PhD. Uptodate
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VI Pancreatic - VI LABORATORY DIAGNOSISOFPANCREATIC DISEASE

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