While on tour, a 32-year-old male musician has presented to the emergency department of a hospital after a concert complaining of severe and sudden abdominal pain

Question

He admits to a history of copious alcohol use in recent years, and his vital signs include temperature 46.8 °C (101.8 °F), blood pressure 89/48 mm Hg, and heart rate 116 beats/minute. Blood work indicates that his serum levels of C-reactive protein, amylase, and lipase are all elevated. Which of the following diagnoses would the care team suspect first?
A)
Hepatitis C
B)
Cholecystitis
C)
Liver cirrhosis
D)
Acute pancreatitis

Answer 1

Ans:
D

Feedback:

Alcohol use, fever, hypotension, and tachycardia are often associated with pancreatitis, as are elevated serum amylase and lipase levels. These enzymes would unlikely rise in cases of hepatitis, cholecystitis, or cirrhosis. The precise mechanisms whereby alcohol exerts its action are largely unknown. The capacity for oxidative and nonoxidative metabolism of ethanol by the pancreas and the harmful by-products that result have been related to the disease process. Hepatitis C has an incubation period. Most adults who acquire the infection usually are asymptomatic. Jaundice is uncommon. Direct measurement of HCV in the serum remains the most accurate test for infection. Cirrhosis represents the end stage of chronic liver disease. The end result is liver failure that affects many organs. The patients usually have anemia, thrombocytopenia, endocrine disorders, skin lesions, azotemia and renal failure, and hepatic encephalopathy.