Pancreas. Pancreatic Enzymes Applications: Acute pancreatitis Obstruction of the pancreatic duct Amylase: Rapid riseSerum: Urine:Persists longer Lipase:

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Presentation transcript:

Pancreas

Pancreatic Enzymes Applications: Acute pancreatitis Obstruction of the pancreatic duct Amylase: Rapid riseSerum: Urine:Persists longer Lipase: Slower rise in the blood; Following prognosis Short-lived lasts longer

Amylase StarchDextrins + Maltose + Maltotriose + Glucose Molecular wt: Salivary depending on ref. Pancreatic The major sources of this enzyme are the pancreas and salivary glands. The normal serum level is made up of approximately 2/3 salivary type and 1/3 pancreatic. Total serum amylase is measured almost exclusively to diagnose acute pancreatitis..

Amylase is elevated in: Acute pancreatitis Carcinoma of the pancreas Epidemic parotitis Acute cholecystitis Penetrating and perforated ulcers Mesentaric thrombosis Intestinal obstruction Ruptured ectopic pregnancy Uremia Postcholangiography Drugs: morphine, codeine

Urinary amylase Due to its small size, amylase is easily filtered by the glomerulus of the kidney and excreted in the urine. Therefore, urinary amylase should be increased in pancreatitis. Current practice is to implant the pancreas such that the exocrine drainage is into the urinary bladder and not the intestine. This makes it very convenient to monitor the function of the pancreas by measuring urinary amylase.

Lipase Mol. Wt. = Lipases are defined as that group of enzymes which hydrolyze the glycerol esters of long-chain fatty acids. Most of the lipase that appears in the serum is produced in the pancreas, but some is also secreted by the gastric and intestinal mucosa. Lipase activity can be demonstrated in leukocytes, in adipose tissue and in breast milk. Calcium is a effector. Colipase is an exocrine pancreatic protein which serves as a cofactor, anchoring lipase at the substrate interface. Serum lipase is primarily measured for the diagnosis of pancreatitis and obstruction of the pancreatic duct.

Acid Phosphatase ACP Prostate + ACP RBC ACP Total ACP Prostate + ACP RBC L-Tartrate ACP RBC (-) ACP Prostate

PSA Elevations Condition Laboratory Values Male with benign prostate hypertrophy 10.2 ± 8.97 ng/ml Prostate Cancer Stage A 9.39 ± 8.09 ng/ml Stage B ± ng/ml Stage C ± ng/ml Stage D ± 50 ng/ml