Deck 34: The Pancreas: Function and Chemical Pathology

Question 1

Diabetes mellitus:
1)can be caused by autoimmune islet cell destruction.
2)can be caused by insulin resistance.
3)can show an abnormal serum amylase in the absence of pancreatitis.
4)is commonly caused by inflammation of the pancreas.

A)1, 2, 3, 4
B)1, 2, 3
C)1, 2, 4
D)1, 3, 4

Answer 1

1, 2, 3

Question 2

Which of the following best summarizes the usefulness of the Ranson criteria for predicting the severity of acute pancreatitis?

A)high positive predictive value, high negative predictive value
B)high positive predictive value, low negative predictive value
C)low positive predictive value, high negative predictive value
D)low positive predictive value, low negative predictive value

Answer 2

low positive predictive value, high negative predictive value

Question 3

In insulinoma, the insulin-to-glucose ratio is ______ along with ______ C-peptide levels.

A)increased, decreased
B)increased, increased
C)decreased, increased
D)decreased, decreased

Answer 3

increased, increased

Question 4

The pancreas is an elongated, flattened pyramidal organ, located mostly behind the ______; the tail points to the ______, and the head is nestled in the ______.

A)stomach, duodenal loop, spleen
B)stomach, spleen, duodenal loop
C)spleen, stomach, duodenal loop
D)spleen, duodenal loop, stomach

Question 5

C-reactive protein (CRP) has been used to evaluate prognosis of pancreatitis.CRP levels of ______ at 48 hours after onset of symptoms are associated with a positive predictive value of about ______ for severe disease and a negative predictive value of _____ for severe disease.

A)>100 mg/L, 86%, 67%
B)>100 mg/L, 67%, 86%
C)>150 mg/L, 86%, 67%
D)>150 mg/L, 67%, 86%

Question 6

Complex carbohydrates are digested by which pancreatic product?

A)elastase
B)lipase
C)a-amylase
D)trypsin

Question 7

The exocrine acini are drained by ductules that combine into a single ______.In most individuals, this joins the common bile duct at the ______, which opens through the duodenal papilla.This orifice is encircled by the ______, so that pancreatic exocrine secretions can flow into the gastrointestinal tract.

A)pancreatic duct, ampulla of Vater, sphincter of Oddi
B)ampulla of Vater, pancreatic duct, sphincter of Oddi
C)pancreatic duct, sphincter of Oddi, ampulla of Vater
D)ampulla of Vater, sphincter of Oddi, pancreatic duct

Question 8

A 56-year-old female presents with glucose intolerance, gallbladder disease, and diarrhea.A large, malignant tumor was found in the head of the pancreas and was causing bile duct obstruction.What is the most probable type of tumor?

A)insulinoma
B)glucagonoma
C)somatostatinoma
D)PPoma

Question 9

Both amylase and lipase rise rapidly with the onset of pancreatic injury.Amylase will remain increased an average of ______; lipase typically remains increased for ______ after injury.

A)3 to 5 days, 5 to 7 days
B)5 to 7 days, 3 to 5 days
C)7 to 9 days, 3 to 5 days
D)10 to 12 days, 5 to 7 days

Question 10

Which of the following can cause acute pancreatitis?

A)cystic fibrosis
B)alcohol abuse
C)biliary tract obstruction by gallstones
D)both b and c

Question 11

Alpha cells:
1)constitute 20% to 30% of the islet cells
2)constitute 60% to 70% of the islet cells
3)produce glucagon
4)produce pro-insulin

A)1, 3
B)2, 3
C)1, 4
D)2, 4

Question 12

Excess production of ______ produces Zollinger-Ellison syndrome, whereas excess production of ______ produces the syndrome of watery diarrhea, hypokalemia, and achlorhydria.

A)gastrin, vasoactive intestinal peptide
B)vasoactive intestinal peptide, gastrin
C)gastrin, somatostatin
D)vasoactive intestinal peptide, somatostatin

Question 13

The principal cations in pancreatic fluid are:
1)sodium
2)potassium
3)calcium
4)magnesium
5)chloride

A)1, 2, 3, 4
B)1, 2, 3, 5
C)2, 3, 4, 5
D)1, 3, 4, 5

Question 14

Nerve fibers in pancreatic tissue stimulate production of:

A)vasoactive intestinal peptide
B)somatostatin
C)enkephalin-related peptides
D)all of the above

Question 15

Which of the following can lead to the release of cholecystokinin, secretin, and gastrin?

A)ingestion of ethanol
B)distention of the duodenum by food
C)both a and b
D)neither a nor b

Question 16

A 45-year-old patient presents with hyperglycemia, weight loss, and a peculiar skin rash.This distinctive combination of symptoms is consistent with _______________.

A)insulinoma
B)glucagonoma
C)somatostatinoma
D)PPoma

Question 17

In cystic fibrosis, pancreatic secretions are of a/an ______ viscosity and a/an ______ volume, which leads to a greatly ______ pancreatic flow.

A)increased, decreased, decreased
B)decreased, increased, increased
C)increased, decreased, increased
D)decreased, increased, decreased