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This is an NBME question. A hospitalized 67 y/o woman has 24 hr history of nausea and abdominal distention. During this period, she vomited 3 times, continued to pass flatus, and has had one bowel movement. She underwent surgical repair of a suprarenal abdominal aortic aneurysm 6 days ago. Post-op, she tolerated clear liquid diet. Her temp is 100.6 deg F, pulse is 95/min and regular, and blood pressure is 120/80 mm Hg. The lungs are clear to auscultation. Heart sounds are normal. The abdomen is distended and tympanitic. There is epigastric tenderness with no guarding or rebound. The surgical incision is intact with inflammation. Labs show:
Hb 10.5 g/dL
Leukocyte count 11,000/mm3
Serum K+ is 4.0
Serum Ca is 9.2
AST 50
ALT 1000
LDH 80
A CT scan of abdomen shows thickened, indurated pancreas with loss of surrounding soft tissue planes. Which of the following is the next step in management?
A) IV Calcium therapy
B) IV Cephalosporin therapy
C) IV Prednisone therapy
D) Enteral hyperalimentation
E) Nasogastric decompression
Anyone know the diagnosis and answer, please explain if you do..
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E.
dont know dx but msy be to prevent aspiration we need to do NG suction
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how ct look in haemorrahgic pancreatitis?
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but why E? what is the problem with the pancreas?
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E
May be pancreas is infected
why ALT is so high?
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E
Patient has acute pancreatitis secondary to intraoperative hypotension (major surgery). Mainstay of treatment is pancreatic rest, i.e. NPO, IVF, and NG decompression.
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studentmle//
Q is wrong.
Amylase 1000U/L not AST
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This is an NBME question. A hospitalized 67 y/o woman has 24 hr history of nausea and abdominal distention. During this period, she vomited 3 times, continued to pass flatus, and has had one bowel movement. She underwent surgical repair of a suprarenal abdominal aortic aneurysm 6 days ago. Post-op, she tolerated clear liquid diet. Her temp is 100.6 deg F, pulse is 95/min and regular, and blood pressure is 120/80 mm Hg. The lungs are clear to auscultation. Heart sounds are normal. The abdomen is distended and tympanitic. There is epigastric tenderness with no guarding or rebound. The surgical incision is intact with inflammation. Labs show:
Hb 10.5 g/dL
Leukocyte count 11,000/mm3
Serum K+ is 4.0
Serum Ca is 9.2
AST 50
ALT 1000
LDH 80
A CT scan of abdomen shows thickened, indurated pancreas with loss of surrounding soft tissue planes. Which of the following is the next step in management?
A) IV Calcium therapy
B) IV Cephalosporin therapy
C) IV Prednisone therapy
D) Enteral hyperalimentation
E) Nasogastric decompression
Anyone know the diagnosis and answer, please explain if you do.
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