Pancreas and Gallbladder Physiology

Question 1

5 different aa cotransporters

Answer 1

neutral, aromatic, imino, positively charged, negatively charged (5 different)

Question 2

Digestive enzymes are made where in pancreas

Answer 2

acinar cells (as zymogens)

Question 3

What activates pancreatic zymogens?

Answer 3

enterokinase/enteropeptidase in duodenum
activates trypsin
trypsin activates others

Question 4

Bicarb comes from where in pancreas?

Answer 4

centroacinar and duct cells

Question 5

Cephalic/gastric phase pancreatic secretions

Answer 5

30% mostly enzyme

activated by parasympathetic efferents and gastrin

Question 6

CCK released by

in response to

Answer 6

I-cells in response to fat/aa

Question 7

Secretin released by

in response to

Answer 7

S-cells in response to H+

Question 8

CCK intracellular pathway

Answer 8

Ca2+

Question 9

Hereditary pancreatitis PRSS1 mutation

Answer 9

autosomal dominant

trypsin mutation

Question 10

Pancreatic insufficiency

Answer 10

90% decrease in enzymes reaching lumen

Question 11

Lipase is inactive in bile salts. What keeps lipase active in bile salts

Answer 11

colipase

Question 12

PRSS1 gene

Answer 12

protease, serine 1
trypsinogen mutation
premature activation of trypsin
autodigestion of pancreas
recurrent episodes of pancreatitis

Question 13

PRSS1 mutations

Answer 13

autosomal dominant

Question 14

How do pancreatic ductal cells respond to secretin?

mechanistically

Answer 14

CFTR puts Cl- into duct
Cl- is exchanged with HCO3- via Cl-/HCO3- antiporter
bicarb secreted into duct

Question 15

GLP-1 (glucose-dependent insulinotropic peptide)
origin
action

Answer 15

GLP-1
from K-cells in sm intestine
increase insulin release, decrease H+ release

Question 16

Leptin and Gherlin

Answer 16

leptin: decreases appetite
Ghrelin: increases appetite, produced by fundus during fasting, lower levels after gastric bypass

Question 17

Stellate cells
location
function
pathology

Answer 17

liver
store vitamin A
lay down collagen in cirrhosis

Question 18

How does ZE syndrome cause decreased uptake of lipids, fat soluble vitamins, and bile salts?

Answer 18

pancreatic lipase only active at more basic pH

too much acid = bad