SAQ 236 – Gastroenterology – severe gallstone pancreatitis

Marked out of 12.00

A 67-year-old man presents with 12 hours of severe upper-abdominal pain, fever, nausea, vomiting, and jaundice. He is exquisitely tender and guarded in the epigastrium and right upper quadrant. BP is 110/60 mmHg, HR 90/min, RR 22/min, and temperature 38.2 C. Initial results are shown below.

Test Result Reference range
Sodium 135 mmol/L 135-145
Potassium 3.9 mmol/L 3.5-5.0
Chloride 100 mmol/L 95-110
Bicarbonate 27 mmol/L 20-31
Urea 4.1 mmol/L 2.7-7.8
Creatinine 62 micromol/L 50-100
Anion gap 8 mmol/L 5-15
Total protein 76 g/L 60-80
Albumin 44 g/L 35-50
ALP 577 IU/L 40-115
ALT 972 IU/L <65
GGT 226 IU/L <55
Total bilirubin 89.4 micromol/L <25
Lipase 8,523 IU/L 8-78

Other than pancreatitis, list three (3) likely differential diagnoses.

(Marked out of 3.0)


/ 3

State three (3) key interpretations of these results.

(Marked out of 3.0)


/ 3

List four (4) factors in this presentation predicting severe disease.

(Marked out of 4.0)


/ 4

List two (2) limitations of Ranson criteria.

(Marked out of 2.0)


/ 2


Total Score: 0 / 12

Percentage: 0%

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