Polycythemia has a plethora of neurological changes. What is the primary cause of these symptoms?

Choice A reason: The nasal compartment refers to the nasal cavity, not specific colored areas. Paranasal sinuses are air-filled cavities around the nose, often highlighted in anatomical diagrams, making this an incorrect term for the described structures.

Choice B reason: Paranasal sinuses, including frontal, ethmoid, sphenoid, and maxillary sinuses, are air-filled cavities around the nasal cavity, often colored in anatomical images. This matches the question’s reference to colored areas, making it the correct term.

Choice C reason: Runny nose describes a symptom (rhinorrhea), not anatomical structures. The question refers to colored areas, likely in a diagram, which aligns with sinuses, not a clinical condition, making this an incorrect choice.

Choice D reason: Olfactory bulbs are neural structures for smell, located above the nasal cavity, not typically colored as distinct areas in sinus diagrams. Paranasal sinuses are the highlighted structures, making this an incorrect term for the described areas.

Choice A reason: Acute pancreatitis is likely, given severe abdominal pain, elevated amylase and lipase, fever, hypotension (89/46 mm Hg), tachycardia (116 bpm), and alcohol history. These are classic signs, with C-reactive protein indicating inflammation, making this the first suspected diagnosis for this patient.

Choice B reason: Cholecystitis causes right upper quadrant pain and fever but is less associated with elevated amylase/lipase or severe hypotension. Pancreatitis aligns better with the patient’s alcohol use, vital signs, and lab results, so this is incorrect as the primary suspicion.

Choice C reason: Hepatitis C may cause liver inflammation but not acute abdominal pain or elevated amylase/lipase. The patient’s acute symptoms, alcohol history, and vital signs point to pancreatitis, not a chronic viral infection, making this incorrect for the first diagnosis.

Choice D reason: Liver cirrhosis is chronic, not acute, and doesn’t typically cause sudden pain or elevated amylase/lipase. Acute pancreatitis matches the patient’s acute presentation, alcohol use, and lab findings, so cirrhosis is incorrect as the initial suspected diagnosis.