Examination: Pancreatic Autodigestion, Gallstone Obstruction, Alcohol-Induced
Pancreatic Injury, Exocrine Pancreatic Enzyme Secretion, Endocrine Insulin and
Glucagon Regulation, Epigastric Abdominal Pain, Serum Amylase Elevation,
Serum Lipase Elevation, Hypocalcemia, Hyperglycemia, Leukocytosis, Cullen’s
Sign, Grey Turner’s Sign, Pancreatic Necrosis, Pseudocyst Formation, Pancreatic
Abscess, Acute Respiratory Distress Syndrome, Hypovolemic Shock, Septic
Shock, Electrolyte Imbalance, Paralytic Ileus, Computed Tomography Imaging,
Endoscopic Retrograde Cholangiopancreatography, Magnetic Resonance
Cholangiopancreatography, Nasogastric Decompression, Opioid Analgesic
Therapy, Proton Pump Inhibitor Therapy, Anticholinergic Antispasmodic
Therapy, Enteral Nutrition Support, Total Parenteral Nutrition, Fluid
Resuscitation Therapy, Laparoscopic Cholecystectomy Intervention, Pancreatic
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Pancreatitis
inflammation of the pancreas
-In U.S., most common cause is gallstones
-Second most common cause is alcohol abuse
functions of the pancreas
Exocrine function of the pancreas: to produce digestive enzymes that assist in breaking down food so
that nutrients can be absorbed.
Endocrine function is making insulin & glucagon.
,What enzymes does the pancreas produce?
Pancreatic Amylase:
Pancreatic amylase is an enzyme that breaks down carbohydrates, specifically starches, into smaller
sugar molecules such as maltose and maltotriose.
It works by hydrolyzing the alpha bonds within the polysaccharide chains of starch, releasing maltose
and maltotriose, which can be further broken down into glucose by other enzymes.
Pancreatic Lipase:
Pancreatic lipase is the primary enzyme responsible for the digestion of fats (lipids) in the small
intestine.
It works by breaking down triglycerides (the primary form of dietary fat) into fatty acids and
monoglycerides, which can be absorbed by intestinal cells for further processing and utilization.
Pancreatic Proteases:
Proteases are a group of enzymes that break down proteins into smaller peptides and amino acids.
The pancreas produces several proteases, including trypsinogen, chymotrypsin, and carboxypeptidases,
which work together to digest dietary proteins.
These enzymes are secreted in inactive forms (zymogens), such as trypsinogen and chymotrypsinogen,
to prevent them from prematurely digesting pancreatic tissue.
Acute Pancreatitis: Etiology
, -Pancreatic ducts become obstructed
-Hypersecretion of the pancreatic enzymes occurs
-These digestive enzymes enter the bile duct where they are activated and, with bile, back up into the
pancreatic duct.
- Pancreatic Autodigestion
Progression of Disease
Back up of digestive enzymes:
Acute inflammation of the pancreas
Necrosis of pancreas
Digestion of vascular walls
Thrombus and hemorrhage
Shock, and even death
Acute Pancreatitis: Clinical Manifestations
EXTREME ABDOMINAL PAIN is the main symptom