Tissue damage in pancreatitis is initially triggered by:
a. insulin toxicity.
b. autoimmune destruction of the pancreas.
c. backup of pancreatic enzymes.
d. hydrochloric acid reflux into the pancreat-ic duct.
ANS: C
In pancreatitis there is backup of pancreatic secretions and activation and release of enzymes (ac-tivated trypsin activates chymotrypsin, lipase, and elastase) within the pancreatic acinar cells. The enzymes become activated, triggering the resulting autodigestion, inflammation, and oxidative stress. The tissue damage associated with pancreatitis is not due to insulin toxicity or to hydro-chloric acid reflux.
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