In the triage unit of your ER you find a 37 yo male with past medical h/o of primary hyperparathyroidism status post right inferior parathyroidectomy 1 year ago, hyperlipidemia, HTN, temporal(giant cell) arteritis being treated with prednisone complaining of severe midepigastric abdominal pain that radiates to the back that started a few hours ago and has not abated in intensity since its start. His pain was so severe he's had two episodes of nonbloody, nonbilious vomiting a few hours ago that scared him to come into the ER at 4am. On questioning his activities earlier in the evening, he mentioned he attended his 20 year high school reunion which had a luxurious open bar selection.
On Physical exam you note a low grade fever, tachypnea, tachycardia, upper abdominal tenderness with guarding but without rebound. You were not able to appreciate any bowel sounds.
Abdominal Exam of Patient
Name these two physical exam findings:
What is your suspected Dx?
Name the 5 risk factors this patient presented with in your initial history of present illness
What are the two most common causes of your patient's disease?
Describe the pathophysiology behind the Most Common Cause of your diagnosis.
What lab study do you want to order to confirm your diagnosis?
What other lab study, not specific to the diagnosis, will be elevated in this patient? Name four of the five areas in the body that produce this quantifiable lab study.
What is the most common cause of this disease in kids?
What kind of shock can you go into because of this disease? How does it relate to Third Space Fluid?
What is the mechanism behind acute pancreatitis induced hypoxemia?
Why can you go into DC during pancreatitis?
Bonus Points: Draw the histologic progression from acute pancreatitis to chronic pancreatitis.
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