yasmeen
Forum Guru
Topics: 71
Posts: 947
|
34 YR OLD MALE PT PRESENTS WITH SEVERE ABDOMINAL PAIN NAUSEA VOMITING AND DEHYDRATION.ON EXAMIN GUTSOUNDS R DIMINISHED AND HE FEELS SLIGHTLY RELIEVED IN LEFT LATERAL POSITION HE IS NOT JAUNDICED ON LAB DATA LIPASE LEVEL IS ELEVATED WHICH IS NOT ASSOCIATED WITH THIS CONDITION
ALCOHOL
GALLSTONES
BLUNT TRAUMA
CANCER
MEDICATIONS
|
| cyra
Moderator
Topics: 29
Posts: 844
|
Blunt trauma
|
| babli
Forum Guru
Topics: 40
Posts: 425
|
CANCER
|
| cyra
Moderator
Topics: 29
Posts: 844
|
Something about the answer I chose was nagging me...the patient has presented with signs of peritonitis....I think all of the options given can be associated with development of peritonitis.I chose blunt trauma because the question gives no clues to the presence/absence of it.Guess I'll wait and see what the others come up with.Good questions there yasmeen.Keep 'em coming!
|
| som
Forum Guru
Topics: 59
Posts: 308
|
i'm confused..no clues pointing to any of the choices in tht matter
|
| mesh
Forum Guru
Topics: 77
Posts: 401
|
its about pancreatitis....so i would say cancer
|
| alenka
Forum Elite
Topics: 22
Posts: 330
|
all of the above conditions can be associated with pancreatitis,i guess.
|
| msyamp
Forum Fanatic
Topics: 60
Posts: 1,462
|
Intereting !!!!!!!!!!!! THERE is no jaundice. and so it cannot be due to stones probably. because to cause perotonities. stnes should land in the ampullary region where the ducts meet. I go for STONES here
___________________
If you think you can You can! If you think you cant you are right again!!
|
| frontal
Forum Guru
Topics: 53
Posts: 421
|
Strange q. Blunt trauma or cancer? msyamp: a stone in the cystic duct or gallbladder will not cause jaundice and may well lead to perforation of the GB to cause peritonitis.
Alcohol and medications on their own would obviously not lead to such a condition, but I guess they're implying indirect events here, like alcohol causing pancreatitis or maybe medications (aspirin) causing peptic perforation...
|
| msyamp
Forum Fanatic
Topics: 60
Posts: 1,462
|
frontal: I think stones are implicated in acute pancratitis because when they block the confluence of the pancreatic and common bile duct at the ampulla. so now here we dont have jaundice. and so tthe stones are not present at the ampulla so cannot cause pancreatitis. I hope you got my piont.
but let us wait for others and the actual answer
___________________
If you think you can You can! If you think you cant you are right again!!
|
| frontal
Forum Guru
Topics: 53
Posts: 421
|
Yes, I was wrong about my previous explanation because they're referring to acute pancreatitis only (elevated lipase- highly specific for acute pan), and all the options given are causes of acute pancreatitis. So, the absence of jaundice is the catch, and in all probablity mysamp has arrived at the correct answer. That's truly cool !
|
| yasmeen
Forum Guru
Topics: 71
Posts: 947
|
 THE ANSWER IS PCANCER .ACUTE PANCREATITIS CAN B CAUSED BY ALCOHOL TRAUMA MEDICINES LIKE FRUSEMIDE CHEMOTHERAPY PANCREATIC CANCER.LIPASE LEVEL ISN,T ELEVATED IF ITS DUE TO CANCER AND PANCREATIC CANCER IUSUALLY PRESENTS AS ASYMPTOMATIC JAUNDICE.
|
| alenka
Forum Elite
Topics: 22
Posts: 330
|
very helpful-thanks,yasmeen.
|
| msyamp
Forum Fanatic
Topics: 60
Posts: 1,462
|
HEy yasmeen. this is bad. you hve said that there is no jaundice and lipase is elevated in the patient in the question. now in the answer you say Pancreatic cancer because he has jaundice and lipase is not elevated???
___________________
If you think you can You can! If you think you cant you are right again!!
|
| ruhighazi
Forum Senior
Topics: 23
Posts: 76
|
msyamp, the patient has acute pancreatitis & as you know alcohol, blunt trauma, medications & gallstone are the common causes of this condition. In acute pancreatitis the levels of amylase & lipase is increased & there is no jaundice as in this case.Despite acute pancreatitis in pancretic cancer we often see jaundice(>80% in carcinoma of the pancreatic head). Sometimes acute pancreatitis is superimposed on pancreatic cancer & in this situation the level of amylase & lipase is elevated.
So the answer of this Q is pancreatic cancer because cancer is commonly associated with jaundice & DON'T give an elevated lipase!
___________________
Ruhighazi
|
| AAAAA
Forum Fanatic
Topics: 156
Posts: 1,991
|
D
___________________
seeking study partner in USMLE, Canadian MCC OSCE examination
|
| achilles
Forum Guru
Topics: 90
Posts: 1,228
|
cancer.
___________________
" it's not whether you get knocked down, it's whether you get up"
" i have miles to go before i sleep "
|
| Jinx
Forum Elite
Topics: 17
Posts: 316
|
cancer
___________________
Life is a journey--enjoy the drive!!
|
| msyamp
Forum Fanatic
Topics: 60
Posts: 1,462
|
oh sorry i was confused. see what happens when we dont see EXCEPT and NOT.
thank you
___________________
If you think you can You can! If you think you cant you are right again!!
|
|
| |
| | | | | | | | | | | | | | | | | | | |
