Updated: 11/15/2018

Pancreatic Enzymes

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Overview
  • Pancreatic enzymes
    • pancreas secretes enzymes required for digestion of carbohydrates, proteins, and lipids
      • carbohydrates
        • pancreas secretes α-amylase in active form
          • digests 1,4-glycosidic bonds of carbohydrates (starch)
      • lipids
        • lipase-colipase
          • pancreas secretes (active) lipase
            • hydrolyzes triglycerides → 1 monoglyceride + 2 fatty acids
            • lipase is inactivated by bile salts
            • pancreas secretes (inactive) procolipase
              • in intestinal lumen, trypsin activates procolipase
                • procolipase (inactive) → colipase (active)
              • colipase displaces inhibitory bile salts 
                • permits digestive functions of lipase
        • phospholipase A2
          • pancreas secretes (inactive) phospholipase A2
            • in intestinal lumen, trypsin activates phospholipase A2
          • hydrolyzes phospholipids → lysolecithin + fatty acids
      • proteins
        • pancreas secretes proteases in inactive forms called proenzymes/zymogens
          • trypsinogen 
          • chymotrypsinogen
          • proelastase
          • procarboxypeptidase A/B
        • activation of pancreatic proteases
          • brush-border enterokinase/enteropeptidase activates trypsinogen 
            • trypsinogen (inactive) → trypsin (active)
          • trypsin catalyzes conversion of inactive precursors to active enzymes
            • trypsinogen → trypsin (positive feedback loop
            • chymotrypsinogen → chymotrypsin
            • proelastase → elastase
            • procarboxypeptidase A/B →carboxypeptidase A/B
        • pancreatic proteases hydrolyze dietary protein to absorbable molecules
          • amino acids, dipeptides, tripeptides
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(M1.GI.14.31) A 55-year-old woman presents with acute onset abdominal pain radiating to her back, nausea, and vomiting. CT scan suggests a diagnosis of acute pancreatitis. The pathogenesis of acute pancreatitis relates to inappropriate activation of trypsinogen to trypsin. Which of the following activates trypsin in normal digestion? Tested Concept

QID: 100096
1

Amylase

6%

(10/155)

2

Lipase

10%

(15/155)

3

Cholecystokinin

12%

(19/155)

4

Enterokinase

66%

(103/155)

5

Secretin

5%

(7/155)

M 1 E

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