Jessica a 44yearold female rock groupie had a big night last

Jessica, a 44-year-old female “rock groupie” had a big night last night at the Aerosmith concert. Upset that she could no longer secure backstage passes like she used to get, she over-indulges in alcohol to help her drown her sorrows. She figures it is okay to do so because she did not drink the previous two nights. She was awoken the next morning by severe abdominal pain in the LUQ. She also feels hot, and takes her temperature at 100 degrees F. Fearing she might get a DWI on the way to the hospital she calls 911. Medics find her in a fetal position on the floor with an increased heart rate. Lab values come back positive for an increase in CRP, amylase, and lipase.

List 3 differential diagnoses and include your reasoning behind each.

What is the best diagnosis? Explain how you came to this conclusion.

Explain the pathophysiology of the following symptoms:

Fever:

Increased heart rate:

Fatigue:

*please use legible handwriting if the answer is not typed, THANK YOU!*

Solution

List 3 differential diagnoses and include your reasoning behind each.

Answer: Acute pancreatitis is main cause of her symptoms mainly associated with her body pancreatic enzymatic values come back positive for an increase in CRP, amylase, and lipase. This is leading inflammation of pancreas due to severe alcohol intake (free radicals released to damage pancreas) as a result acute pancreatitis

Cholecystitis: mainly due to vague abdominal pain which is due to epigastric region upper quadrant pain represents inflammation of pancreas

Choledocholithiasis: it can be observed by CT or MRI scan or by endoscopy

Perforated peptic ulcer or bowel infarction: it can be observed due to higher levels of serum lipase greater than upper limit

What is the best diagnosis? Explain how you came to this conclusion.

Imaging is the best concluded diagnosis to unravel the this “acute pancreatitis or blockade of pancreatic duct” in which mainly CT, MRI, abdominal ultrasound imaging are preferred

Explain the pathophysiology of the following symptoms:

Fever: She also feels hot due to inadequate pancreatic secretion & inflammation due to inflammatory factors result in 100 degrees of body temperature

Increased heart rate: Higher blood pressure due to inflammation resulted by alcohol induced upper quadrant pain or internal bleeding

Fatigue: pain and low metabolic activity may lead to jaundice further fatigue due to low amount of energy