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2

Alcohol nourished this body

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3

Patient:

A 38 year landscaper is brought to theE.R. by his foreman.

Symptoms Shock

Severe pain in upper abdomen and back

Vomiting Shortness of breath

Muscle weakness/pain

Weight loss

Putty feces

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Urine:

- glucose +, protein+, tea colorBlood:

- glucose , free fatty acids, protein =

- amylase and lipase , CK+, myoglobine

- Hb =, leucos =; normal diff.

- CT: deviating structures of ductus

pancreaticus, local calcifications

Labs

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D.D.

Acute pancreatitis, Type 2 Diabetes Mellitus,

Rhabdomyolysis

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The pancreasEXO

ENDO

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Control of gastrointestinalsecretions

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TrypsinogenChymotrypsinogen

ProelastaseProprotease EProcarboxypeptidase BAmylaseLipaseColipaseRNAse

DNAseTrypsine inhibitor

Production ofpancreatic

enzymes

Boron & Boulpaep

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Plasma glucose con. Activates

Insulin release

( 5.6 mM)

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ActivityEpinephrine

Skeletal

muscle

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Diabetes

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Aminoacid ketoacid interaction

Aminoacid:

Alanine

Aspartate

Glutamate

-ketoacid:

Pyruvic acid

Oxaalacetate

-ketoglutarate

Important pairs:

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DermatomesAreas of cutaneous sensory innervation from aspinal segment

Boron & Boulpaep, Medical Physiology

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Literature Guyton; Textbook of Medical Physiology

Boron & Boulpaep; Medical Physiology Kumar; Pathological Basis of Disease

Stryer; Biochemistry Alberts; Molecular Biology of the Cell.

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