Difficulty: Medium
Average Score: 93%
Practice
Mr. Jefferson is a 59-year-old male who presents to the emergency department complaining of severe abdominal pain. His medical history is significant for dyslipidemia, and he takes 40 mgof simvastatin daily. He admits to drinking 6 to 10 bottles of beer nightly and to smoking 1 packs of cigarettes a day. He denies any history of chest pain or cardiovascular disease. He was in his usual state of good health until a couple of hours ago, when he developed this acute onset of severe pain in the upper abdomen. He says that he tried to wait it out at home but it was so bad he finally came in. His vital signs are as follows temperature 99.1F, pulse 129 bpm, respirations 22 breaths per minute, and blood pressure 13784 mm Hg. The abdomen is diffusely tender to palpation with some guarding but no rebound tenderness. The AGACNP anticipates that which of the following laboratory tests will be abnormal?
Correct answer
A
Rationale
Given the patient's presentation of acute onset severe abdominal pain, the AGACNP anticipates abnormalities in serum amylase and lipase levels, as this can indicate pancreatitis. The presence of symptoms such as severe upper abdominal pain, along with the patient's risk factors such as heavy alcohol consumption, smoking, and dyslipidemia, increase suspicion for acute pancreatitis. Additionally, the evaluation of serum glucose levels is important to assess for potential hyperglycemia, which can be seen in acute pancreatitis. Liver function enzymes and basic metabolic panel may also be abnormal in the setting of pancreatitis; however, the most specific and sensitive tests for diagnosing acute pancreatitis are serum amylase and lipase levels.