shawky2005
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1) the diagnostic level of serum amylase in acute pancreatitis is about :
A 1000 units
B 10000 units
C 100 units
D 10 units
2) The most specific enzyme for diagnosis of acute pancreatits is :
A serum amylase
B urine amylase
C serum lipase
D serum gastrin
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| bluedusk
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1. not sure....
2. lipase.
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| Moni79
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Serum amylase is the most frequently ordered test to diagnose acute pancreatitis. It rises within 6 to 12 hours of onset, and is cleared fairly rapidly from the blood (half-life 10 hours). In uncomplicated attacks, serum amylase is usually elevated for three to five days.
The sensitivity of serum amylase for detecting acute pancreatitis is difficult to assess because an elevated amylase concentration is often required to make the diagnosis.
The serum amylase concentration in acute pancreatitis is usually more than three times the upper limit of normal. However, the serum amylase may be normal or minimally elevated in patients with fatal pancreatitis or those who have a mild attack, an attack superimposed on chronic pancreatitis, or who are recovering from acute pancreatitis. With other causes of hyperamylasemia, the serum amylase is usually less than the upper limit of normal.
Hyperamylasuria occurs in acute pancreatitis because the normal 3 percent amylase-to-creatinine clearance ratio (ACCR), which indicates that approximately 3 percent of filtered amylase is excreted, increases to approximately 10 percent
The sensitivity of serum lipase for the diagnosis of acute pancreatitis ranges from 85 to 100 percent in various reports. Lipase measurement is more specific than serum amylase and urinary total amylase in diagnostic accuracy both on day one and day three. However, nonspecific elevations of lipase have been reported in almost as many diseases as amylase. Serum lipase levels may be especially useful in patients with alcoholic pancreatitis presenting late to the physician
Evaluating tests for acute pancreatitis.
AU - Agarwal N; Pitchumoni CS; Sivaprasad AV
SO - Am J Gastroenterol 1990 Apr;85(4):356-66.
Evaluation of amylase and lipase in the diagnosis of acute pancreatitis.
AU - Treacy J; Williams A; Bais R; Willson K; Worthley C; Reece J; Bessell J; Thomas D
SO - ANZ J Surg 2001 Oct;71(10):577-82.
A critical evaluation of laboratory tests in acute pancreatitis.
AU - Yadav D; Agarwal N; Pitchumoni CS
SO - Am J Gastroenterol 2002 Jun;97(6):1309-18.
I hope this helps!
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| shawky2005
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mani thanks but i cant understand anything from your text above and the answer is not present ....
the diagnostic level of serum amylase for acute pancreatitis is 1000 units/dl
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| onenightdRŽ
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there is no diagnostic level ı think. serum amylase and lipase are elevated- usually more thhan 3 times the upper limit of normal- within 24 hours in 90% of cases. lipase remains elevated longer than amylase.
ı think learning RANSOSN'S CRITERIA is more important than these.
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| mani
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sorry shawky, i dont know what happened there. i totally agree with ur replies. the amylas eabove 1000 units is very highly suggestive
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| onenightdRŽ
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yes mani; suggestive but NOT DIAGNOSTIC :evil:
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| shawky2005
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sorry mani as i confused between you and moni 79
and for onenightdR i read this information in a surgical book i obtain ... i agree with you that in acute pancreatitis the serum amylase is increased up to 3 times .. ok ... and i read in that surgical level the diagnostic level of serum amylase in acute pancreatitis is 1000 units and if the level is below that and we still suspecting acute pancreatitis we should do other investigations to confirm the diagnosis especially serum lipase ... this is what i read ... an if i am wrong i will be so sorry for writing a wrong information
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