The primary causes of duodenal ulcers include:

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.

Choice A reason:
Fatty acids are essential components of many lipids, but they are not the primary building blocks of bile salts. Bile salts are synthesized from cholesterol. Fatty acids mainly function as energy storage molecules and are involved in forming complex lipids, like triglycerides and phospholipids. They don't participate directly in the production of bile salts, which are crucial for digesting and absorbing dietary fats.

Choice B reason:
Testosterone is a steroid hormone that plays a vital role in male reproductive tissues and secondary sexual characteristics. It is not involved in the synthesis of bile salts. Bile salts are derived from cholesterol, not hormones. Testosterone’s primary function is related to endocrine activities rather than hepatic functions like bile salt synthesis.

Choice C reason:
Cholesterol is the correct answer. Bile salts are synthesized from cholesterol in the liver. This process involves the conversion of cholesterol into bile acids, which are then conjugated with amino acids to form bile salts. These bile salts are critical for the digestion and absorption of fats in the small intestine. The liver’s conversion of cholesterol to bile salts helps in maintaining cholesterol homeostasis in the body.

Choice D reason:
Lecithin is a type of phospholipid that plays a significant role in cell membrane structure and function. While it is an important component of bile, it is not the substance from which bile salts are synthesized. Lecithin helps in the emulsification of fats in the digestive process but is not a precursor to bile salts. The synthesis of bile salts specifically involves cholesterol.