Typical exam stem
A patient presents with severe epigastric pain radiating to the back and elevated lipase. How would you investigate and manage acute pancreatitis?
Active exam mode
Plan the case before reading, then mark sections, reveal pearls and self-rate the viva.
1. Sixty-second answer plan
1:00Before reading the notes, say or write your assessment, investigations and management structure.
2. Section checklist
Mark each section only after you can explain its main decision points without reading.
3. Exam-pearl flashcards
Try to predict the pearl before revealing it.
4. Viva drill
Answer aloud before rating yourself. Anything marked “review” stays visible in your progress.
What are the diagnostic criteria for acute pancreatitis?
Progress is saved on this device. Use “Reset session” when you want a fresh attempt.
Confirm the diagnosis
Acute pancreatitis is usually diagnosed when at least two of three features are present: typical abdominal pain, a significant rise in pancreatic enzymes and characteristic imaging. Routine early CT is not necessary when the diagnosis is already clear and the patient is improving.
Find the cause
- Gallstones and alcohol are common causes.
- Review triglycerides, calcium, medications, recent procedures and trauma when appropriate.
- Use transabdominal ultrasound to evaluate for biliary disease.
- Consider less common structural or malignant causes when the usual explanation is absent.
Early management
Provide appropriate fluid resuscitation guided by repeated clinical assessment, adequate analgesia and early nutritional support as tolerated. Monitor for organ failure rather than relying on enzyme trends to determine severity. Antibiotics are not used routinely for uncomplicated sterile pancreatitis.
Urgent ERCP is reserved for selected biliary pancreatitis scenarios such as associated cholangitis or persistent biliary obstruction. Patients with necrosis, persistent organ failure or local complications require multidisciplinary specialist care.
Guideline source for further reading
This page is an original exam-revision summary. For clinical decisions, use current local protocols and the primary guidance below.