Gastrointestinal System Disorders Q 87 - Gyan Darpan : Learning Portal
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Friday, 15 April 2022

Gastrointestinal System Disorders Q 87

What laboratory finding is the primary diagnostic indicator for pancreatitis?
    A. Elevated blood urea nitrogen (BUN)
    B. Elevated serum lipase
    C. Elevated aspartate aminotransferase (AST)
    D. Increased lactate dehydrogenase (LD)

Correct Answer: B. Elevated serum lipase

Elevation of serum lipase is the most reliable indicator of pancreatitis because this enzyme is produced solely by the pancreas. Serum lipase typically increases 3–6 hours after the onset of acute pancreatitis and usually peaks at 24 hours. Unlike amylase, there is significant reabsorption of lipase in the renal tubules so the serum concentrations remain elevated for 8–14 days.

Option A: A client’s BUN is typically elevated in relation to renal dysfunction. A BUN test is done to see how well the kidneys are working. If the kidneys are not able to remove urea from the blood normally, the BUN level rises. Heart failure, dehydration, or a diet high in protein can also make the BUN level higher. Liver disease or damage can lower the BUN level.
Option C: A client’s AST is typically elevated in relation to liver dysfunction. The elevated AST-to-ALT ratio in alcoholic liver disease results in part from the depletion of vitamin B6 (pyridoxine) in chronic alcoholics. ALT and AST both use pyridoxine as a coenzyme, but the synthesis of ALT is more strongly inhibited by pyridoxine deficiency than is the synthesis of AST.
Option D: A client’s LD is typically elevated in relation to damaged cardiac muscle. Usually, LDH isoenzyme levels increase 24–72 hours following myocardial infarction and reach a peak concentration in 3–4 days. Glycogen phosphorylase BB is released into circulation 2–4 h after onset of cardiac ischemia and returns to baseline levels 1–2 days after acute myocardial infarction, making it an early marker.

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