MRMAVERICK
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A 34-year-old healthy woman has the sudden onset of severe abdominal pain. On physical examination she is afebrile. The pain is centered in the mid-epigastric region, though there is marked diffuse tenderness in all quadrants. Bowel sounds are absent. No masses are palpable. Laboratory studies show her serum amylase is 410 U/L and lipase is 610 U/L. Which of the following laboratory test findings is most likely to be present in this woman?
A Hypercholesterolemia
B Positive urea breath test
C Hypercalcemia
D Elevated sweat chloride
E Positive serology for HBsAg
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| hatiifa
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most common cause for acute pancreatitis is gall stones which could be associated with hypercholestrolemia. I think A.
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| johnnyu041
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I agree its hypercholesterolemia but im just wondering where will you find elevated sweat chloride?
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| star1
Forum Guru
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A is correct
A Hypercholesterolemia
B Positive urea breath test ....... This test is for Helicobactor Pylori and this bug is associated with ulcer disease
C Hypercalcemia..... In pancreatitis we have hypocalcemia due to Fat necrosis
D Elevated sweat chloride .......This test is to detect cystic fibrosis, Yes cystic fibrosis can be invloved in pancreatitis but this disease occur more commonly in younger age and particularly in Ashkenzu ppl
E Positive serology for HBsAg ....... I dont think this has anything with Pancreatitis
GL
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| NE
Forum Guru
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I think it is C- hypercalcemia is a metabolic cause for PA! It is not necessary to have hypercholesterolemia for gallstone!
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| johnnyu041
Forum Junior
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Yes but the questoin says "most likely" and in the book Acute Pancreatitis is most often associated with hypocalcemia...
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| me007
Forum Guru
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primary hyperparathyroidism
most cases are asymptomatic and discovered incidentally.
clinical -
1 - renal stones
2 - peptic ulcer disease - hypercalcemia stimulates gastrin release
3 - acute pancreatitis (what is most likely in this case) - hypercalcemia activates phospholipase in pancreas.
from Goljan Pathology
looks like C?
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| hatiifa
Forum Newbie
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hypocalcemia occurs due to saponification reaction of the free fatty acids which precipitates plasma calcium. so , even if the cause was hypecalcemia, serum calcium would decrease after calcium precipitation.
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| arunangsude
Forum Newbie
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so what is the ultimate answer?
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| johnnyu041
Forum Junior
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Okay Kaplans notes say that Hypercalcemia is a cause of pancreatitis and then i looked up in a medicine book that while hypertriglyceridemia can cause pancreatitis, it doesnt mention anything about hypercholesterolemia....so im gonna go with C....
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| kingusmle
Forum Elite
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C is the answer .epigastric pain is associated w AP not gallstones
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| Ancylostoma
Forum Guru
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I want to know why noone recognised the fact that bowels sounds are absent and there is a presence of diffuse abdominal pain. Maybe I'm crazy? Pancreatitis alone would be a sharp pain radiating retrosternally. this makes me think she has bowel obstruction on top of the pacreatitis and leads me to a diagnoses of cystic fibrosis. Do a sweat test. i cant be sure, but there is such a thing as adult onset cystic fibrosis.
D
Edited by Ancylostoma on 01/12/07 - 06:23 PM
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| babydoc4usmle
Forum Guru
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i think this question has to go from the head.
what is the disease? PANCREATITIS (evebody agrees)
what is the most commo cause of pancreatitis? ALCOHOL ABUSE and GALLSTONES
what is the most common cause of gallstones? HYPERCHOLESTEROLEMIA
as for Ca: pancreatitis is one of the CAUSES of HYPOCALCEMIA
in HYPERCALCEMIA there must be something else, not just pancreatitis, besides i don't think that it can be without any other history
please, tell me if i am wrong
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| babydoc4usmle
Forum Guru
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Mr.Maverick, why don't you give us correct answer?
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| MRMAVERICK
Forum Guru
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(A) Incorrect. Hypercholesterolemia is not a risk for pancreatitis. However, hypertriglyceridemia is a cause for pancreatitis, though the triglyceride level must be quite high--probably over 1000 mg/dl.
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| MRMAVERICK
Forum Guru
Topics: 42
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(C) CORRECT. This is a cause for pancreatitis that can be found in persons with hyperparathyroidism.
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| babydoc4usmle
Forum Guru
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i give up 
time to retire
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