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  #1  
Old 10-30-2011
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Arrow Ultimate prognosis

A 29-year-old alcoholic man is admitted to the hospital with severe epigastric pain radiating straight through to the back. At the time of admission he has a serum amylase of 1,200 U/L, a hematocrit of 39%, a leukocyte count of 18,000/mm3, a serum glucose level of 220 mg/dL, and a serum calcium level of 7.2 mg/dL. He is placed on nasogastric suction and intravenous fluids, and given intravenous calcium gluconate. By the next morning his hematocrit has decreased to 31% and his serum calcium is 6.1 mg/dL. Management with which of the following could improve his ultimate prognosis?
A. Antacids
B. Antibiotics
C. Anticholinergics
D. Daily CT scans
E. Surgical resection
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  #2  
Old 10-30-2011
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hematocrit drops too quicky, so surgery is the choice
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  #3  
Old 10-31-2011
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daily CT scans
i guess this is hemorrhagic pancreatitis so we need to c if abscess develops.which can be diagnosed on CT??
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  #4  
Old 10-31-2011
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The correct answer is D. The clinical and laboratory picture described is that of severe hemorrhagic pancreatitis, with poor prognosis. Actually all of the other items (choices A, B, C, and E) remain controversial or unproven. The only option given that has become part of the standard of care for severe hemorrhagic pancreatitis is the addition of a daily CT scan. Many patients who go on to die from acute hemorrhagic pancreatitis do so because they develop pancreatic infection, which can be diagnosed with a CT-guided needle aspiration. .
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Gastroenterology-, Internal-Medicine-, Step-2-Questions

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