While on tour, a 32 year old male musician has presented to the emergency department of a hospital after a concert complaining of severe and sudden abdominal pain. He admits to a history of copious alcohol use in recent years, and his vital signs include temperature 101.8°F, blood pressure 89/48 mm HG and heart rate 116 beats per minute. Blood work indicates that his serum levels of C-reactive protein, amylase and lipase are all elevated. Which of the following diagnoses would the care team suspect first?
Liver cirrhosis
Acute pancreatitis
Hepatitis C
Cholecystitis
The Correct Answer is B
A. Liver cirrhosis: Although chronic alcohol use can cause cirrhosis, the acute presentation with severe abdominal pain, fever, hypotension, and elevated amylase and lipase is more indicative of pancreatitis rather than cirrhosis, which typically presents with chronic symptoms.
B. Acute pancreatitis: Sudden severe abdominal pain, fever, low blood pressure, and elevated inflammatory markers like C-reactive protein along with elevated pancreatic enzymes (amylase and lipase) strongly suggest acute pancreatitis. Alcohol use is a common risk factor for this condition.
C. Hepatitis C: This usually presents with more chronic symptoms related to liver dysfunction fatigue, nausea, dark urine, and jaundice. It does not cause elevated pancreatic enzymes or acute abdominal pain.
D. Cholecystitis: While cholecystitis causes abdominal pain and fever, it does not typically cause elevated amylase and lipase levels unless there is associated pancreatitis. The vital signs and enzyme elevations point more directly to pancreatitis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. This option incorrectly matches the terms: cholelithiasis refers to gallstones, not stones in the common bile duct; cholecystitis is inflammation of the gallbladder, not the common bile duct; choledocholithiasis refers to stones in the common bile duct, not inflammation.
B. This option reverses definitions: cholangitis is inflammation of the common bile duct, not gallstones; cholecystitis is inflammation of the gallbladder, not stones in the common bile duct; choledocholithiasis refers to stones in the common bile duct, not inflammation.
C. This option mislabels choledocholithiasis as inflammation of the common bile duct, but it actually refers to stones in the common bile duct; cholecystitis is inflammation of the gallbladder, not stones in the common bile duct; cholangitis is inflammation of the common bile duct, not the gallbladder.
D. This option correctly matches the terms: cholelithiasis means gallstones; choledocholithiasis refers to stones in the common bile duct; cholangitis is inflammation of the common bile duct; cholecystitis is inflammation of the gallbladder.
Correct Answer is D
Explanation
A. Presence of insulin autoantibodies that destroy beta cells in the pancreas: This describes the autoimmune process characteristic of Type 1 diabetes mellitus, where the immune system attacks pancreatic beta cells, leading to insulin deficiency.
B. Need for lifelong insulin injections: Lifelong insulin therapy is typically required in Type 1 diabetes due to absolute insulin deficiency. Many individuals with Type 2 diabetes can manage their condition initially with lifestyle changes and oral medications.
C. Increase of glucagon secretion from beta cells of the pancreas: Glucagon is secreted by alpha cells, not beta cells, in the pancreas. Dysregulation of glucagon contributes to hyperglycemia but is not a defining feature distinguishing Type 2 diabetes.
D. Resistance to insulin by insulin-sensitive tissues: Type 2 diabetes is primarily characterized by insulin resistance, where muscle, fat, and liver cells do not respond properly to insulin, leading to elevated blood glucose levels despite normal or increased insulin production. This resistance is a hallmark feature distinguishing it from Type 1 diabetes.
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