A 31-year-old female is diagnosed with acute pancreatitis. Which of the following will be part of the treatment plan?

nasogastric suctioning

narcotic analgesics

steroid therapy

restriction of food intake

IV fluids

Answer and Explanation

Correct Answer : A,B,D,E

Choice A reason:
Nasogastric suctioning is a common intervention in managing acute pancreatitis when there is severe nausea, vomiting, or evidence of intestinal obstruction. The procedure helps to decompress the stomach, reduce pancreatic stimulation, and minimize the risk of aspiration. It is particularly indicated for patients who cannot tolerate oral intake or exhibit signs of paralytic ileus. By reducing gastric distension and suppressing pancreatic secretions, nasogastric suctioning aids in alleviating symptoms and improving patient outcomes.
Choice B reason:
Narcotic analgesics are essential for controlling the intense abdominal pain that accompanies acute pancreatitis. The pain arises due to inflammation and autodigestion of pancreatic tissue by enzymes like trypsin. Medications such as morphine or hydromorphone provide effective relief by acting on opioid receptors in the central nervous system. Adequate pain management is crucial not only for patient comfort but also to mitigate stress-related complications that can worsen inflammation or systemic effects.
Choice C reason:
Steroid therapy is generally not part of the treatment for acute pancreatitis unless there is an associated autoimmune component. In most cases, the use of steroids could exacerbate the condition or increase the risk of complications such as infections. As such, this option is not appropriate in routine management of acute pancreatitis.
Choice D reason:
Restriction of food intake is a critical component of the treatment plan. Fasting minimizes pancreatic stimulation and allows the inflamed pancreas to rest. Typically, patients are kept nil by mouth (NPO) until their symptoms subside. Nutrition can then be gradually reintroduced, starting with clear liquids and advancing as tolerated. Enteral feeding via a nasojejunal tube may be considered if prolonged fasting is required.
Choice E reason:
IV fluids are a cornerstone of acute pancreatitis management. Fluid resuscitation is necessary to address hypovolemia caused by fluid shifts, vomiting, and third-spacing of fluids into inflamed tissues. Aggressive hydration with isotonic crystalloids, such as normal saline or lactated Ringer's solution, helps maintain hemodynamic stability and improves microcirculation in the pancreas, reducing the risk of complications such as necrosis or organ failure.

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Correct Answer is C

Explanation

Choice A reason:
Abdominal ultrasound and chest X-ray are not the first-line tests for a patient presenting with these symptoms. While they can be useful in assessing certain conditions, the priority in this case is to rule out cardiac causes, especially given the symptoms that could indicate a cardiac event.

Choice B reason:
Testing the acidity of gastric contents and assessing the throat is not relevant for the initial evaluation of these symptoms. While gastrointestinal issues can present with similar symptoms, the first step should be to rule out more serious cardiac causes.

Choice C reason:
Electrocardiogram (EKG) and serum troponin levels are the correct answer. These tests are critical in assessing cardiac function and identifying potential myocardial infarction or other cardiac issues. Given the patient's symptoms, which can be indicative of a cardiac event, these tests are prioritized to rule out any immediate cardiac threats.

Choice D reason:
Abdominal X-ray and colonoscopy are not appropriate first-line tests in this scenario. While they may be necessary later to investigate gastrointestinal issues, the primary concern given the patient's symptoms is to rule out cardiac events with an EKG and serum troponin levels.

A. Arterial emboli from heart valve. B. Atherosclerosis. C. Idiopathic vasospasm. D. Venous emboli.

Correct Answer is B

Explanation

Choice A reason:
Arterial emboli from a heart valve are not the most common cause of myocardial ischemia. While emboli can obstruct blood flow and cause ischemia, they are a less common cause compared to atherosclerosis. Embolic events typically result from conditions like atrial fibrillation or valvular heart disease but do not account for the majority of myocardial ischemia cases.

Choice B reason:
Atherosclerosis is the most common cause of myocardial ischemia. It involves the buildup of plaque within the coronary arteries, leading to reduced blood flow and oxygen supply to the heart muscle. This condition is a leading cause of coronary artery disease and is responsible for the majority of myocardial ischemia cases.

Choice C reason:
Idiopathic vasospasm, although a cause of myocardial ischemia, is not as common as atherosclerosis. Vasospasm refers to the sudden constriction of a coronary artery, which can reduce blood flow to the heart muscle. However, it accounts for a smaller percentage of ischemia cases compared to the widespread prevalence of atherosclerosis.

Choice D reason:
Venous emboli are typically associated with conditions such as deep vein thrombosis and pulmonary embolism, affecting the venous circulation rather than the coronary arteries. They do not commonly cause myocardial ischemia, which primarily involves the coronary arteries and arterial blockages.

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A 31-year-old female is diagnosed with acute pancreatitis. Which of the following will be part of the treatment plan?

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