Digestive System: Amylase, Lipase, Pancreatitis, Malabsorption

Co-lipase and Bile salts

Lipase requires the following:

Amylose

Long, unbranched-chain of glucose molecules

Signs and Symptoms of Acute pancreatitis

Sudden upper abdominal pain, may vomit, fever, jaundice occasionally present

Fecal Fat test

Test for Malabsorption

Serum or Heparinized Plasma

The preferred specimen for amylase analysis

Amylose and Amylopectin

These are the units of starch

Total Bilirubin INCREASED, Bc INCREASED, Bu NORMAL

These molecules are seen in pancreatitis when there is biliary obstruction present

Pancreatic Amylase

This amylase can only function under alkaline p.H

salivary Amylase

This amylase is inactivated when it reaches the stomach's acidic pH

a-amylase

This amylase is of human origin

a-amylase

This amylase type attacks the a-1,4-glycosidic bonds

B-amylase

This amylase type only acts on the terminal end of starch

B-amylase

This amylase type splits off two glucose units at a time

a-1,4-Glycosidic Bonds

This bond is where amylase attacks the starch subunits

Amylase

This enzyme catalyzes the breakdown of starch and glycogen

Amylase

This enzyme has two sources; the salivary gland and the pancreatic acinar cells

Lipase

This enzyme hydrolyzes ester linkages of triglycerides

Lipase

This enzyme is more specific for acute pancreatitis

B-amylase

This form of amylase is found in plants and bacteria

Cl ions

This is an activator of Amylase

Obstruction of pancreatic ducts

This is due to gallstones or cancer, the enzyme cannot be excreted into duodenum and backs up into the circulation. You witness an increase in serum amylase.

pH 6.9-7.2

This is the optimal pH for Amylase

Fecal Occult blood test

This test is used for the diagnosis of colerectal cancer

Wet chemistry & Dry Vitros chemistry

What are the general measuring principles for Amylase

B-amylase and a-amylase

What are the two types of Amylase

Lipase and Amylase

What is increased in the serum when there is necrosis in the pancreatic cells?

NADH

What is the final product that is measured through spectrophometry in the analysis of Amylase?

Maltose and some glucose

When Amylase splits starch it forms these simplistic sugars

Calcification of the pancreas

When lipase is released due to pancreatitis, it will digest adjacent fats. The fatty acids will combine with calcium to form this:

Increase in absorbance @ 340nm

When measuring amylase by wet chemistry, the machine is checking:

Chronic Pancreatitis

You witness a patient sample that has a slightly higher Amylase level (still above reference range). This is seen in:

Acute Pancreatitis

You witness a patient sample that shows a strong elevation in Amylase levels post attack. After 3-4 days the patient's Amylase levels return to normal. This is seen in:

Metalloenzyme: Ca2+

a-amylase is considered a ____________ enzyme

Acute Pancreatitis

Abrupt onset, short duration, no permanent damage

In the Urine

Amylase is the only plasma enzyme that is found here:

Amylopectin

Branched-chain of glucose

Fecal Fat test method

Collect stool for 3 days, patient records amount of fat consumed, extract fats with solvents, hyrdolyze fatty acids, titrate against base

Chronic Pancreatitis

Does not resolve itself, slow destruction of pancreas, irreversible damage

Reflectance @ 540nm

How is the product of the amylase reaction measured in the Dry Chemistry method?

Hypocalcemia

In pancreatitis, calcium is used by the newly freed fatty acids taking them out of the system. This is known as__________

Chromogen

In the Dry Measuring analysis of amylase, what is the product?

Maltotetrose

In the Wet measuring of Amylase what is the Substrate?

Pancreatitis

Inflammation of the pancreas

Pathophysiology of acute pancreatitis

Obstructive gallstone rechannels the bile into pancreas --> activates pancreatic enzymes --> leads to enzymatic auto-digestion of the pancreatic cells

Islet cells

Pancreas Endocrine cell type

Acinar Cells

Pancreas exocrine cell type

Exocrine

Production, storage and release of proenzymes, enzymes and bicarbonate from pancreas

Increased serum glucose

Result of the abnormal endocrine function of pancreatic cells in pancreatitis

Endocrine

Secretion of hormones to regulate blood lucose levels- insulin and Glucagon- in the pancreas

Steatorrhea

Sign of pancreatic exocrine enzyme insufficiency

Insufficient Cl ion

Source of error in measuring Amylase

Malabsorption Syndrome

failure to absorb one or more dietary constituents. Usually a result of pancreatic exocrine disease or intestinal disease