Mon22November1200AM 17

A 45-year-old male presents with severe epigastric pain and is diagnosed with acute pancreatitis. Which of the following are/is true?

True / False

A poor prognosis may be indicated by a serum urea >10 mmol/l Incorrect answer selected

A necrotic pancreas is an indication for early surgery Correct

Acute pancreatitis may be associated with hyperglycaemia Correct

The serum calcium is usually high Correct

A 'sentinel loop' may be visible on the abdominal x ray Correct

Explanation

Surgery may be required for drainage of an abscess or pseudocyst, but the resection of a necrotic pancreas early in the disease has a high mortality.

Poor prognosis may be indicated by

age >55 years

systolic blood pressure <90 mmHg

white cell count >15 x 109

temperature >39C

glucose >10 mmol/l

PaO2 <8 kPa

urea >15 mmol/l

calcium <2 mmol/l

haematocrit reduced by over 0.1

abnormal liver function tests.

The classical laboratory findings include

a raised serum amylase

leukocytosis

hyperglycaemia

hypocalcaemia

hypoproteinaemia

hyperlipidaemia.

An abdominal x ray may reveal a 'sentinel loop' of small bowel overlying the pancreas. The chest x ray can show a wide range of pathology.

Acute pancreatitis is an auto-digestive process which is commonly associated with biliary tract disease or excessive alcohol intake. Other recognised causes include:

abdominal trauma

mumps

hypothermia

diuretic

steroid therapy.

Answer Statistics

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Average score: 79.27%

Times answered: 275