I'm doing a quiz and I'm being recorded downstairs. Ask somebody downstairs.

Profile Ms. Samuel is a 52 year old female patient with the history of liver
cirrhosis, secondary two alcohol abuse. The patient called Nine. One one. She
developed sudden onset of severe epiastic pain, the radiation to the back, relieved
by sitting up and leaning forward.

The client reported her pain developed about two to three days ago but was
significantly worse than shortly after having a few drinks.

She was pale diaphragtic on arrival to the hospital and appeared very
uncomfortable. Her abdomen was distended in dysphypnia was also noted during
general survey subjective data.

Samuels reported severe abdominal pain with feelings of nausea. Also reported that
she has noticed.

Increasing. Ronald Sentinel, which has been marked with her increasingly shortness
of breath. She experiences shortness of breath, especially when lying flat on bed
and has not been sleeping very well over the last few days or three weeks. Psycho
social data see she smokes a pack of cigarettes per day, consumes three to four
beers every night of the week. That's a lot.

She also admits to occasionally having other liquor. She's currently unemployed and
lives alone. Past medical history hypertension type two diabetic. She's a smoker,
alcohol abuser, alcoholic liver cirrhosis.

Physical examination, vital signs, blood pressure, low pulse, high temperature
respirations are elevated.

Oxygen is low on room air. She may need oxygen integrated. Clinical jaundice yellow
square so her eyes are yellow. Her Pura, Spider Neva and bruises were noted. Dry
skin and perpetuous wear noted cool clammy skin noted this pulpation abdomen,
abdominal liver small in size and firm on palpation.

Nausea, vomiting four times since onset. Okay, so that's normal.

Okay. Nero no extraxes hand flapping tremors was noted. Orientation to person but
not but confused to place in time. I can also be flew over extremities above the
knee. Bilateral has three plus pitting edema.

So yeah, a lot of fluid fluid overload test weight. Blood cells is low, hemoglobin
is completely count is low, glucose is elevated, sodium is low, albumin is super
low.

Ammonia is high conjugated protein, 18 seconds a little bit longer.

Wait, but that's how you check if somebody has elevated too. So liver enzymes were
also elevated. Diagnostic test CD scan of the abdomen noted significant pancreatic
inflammation, ultrasonography and symptoms noted on physical exam confirmed the
presence of portal hypertension. Severus Megali was also noted on ultrasound. Upper
gastrointestinal endoscopy concluded presence of assault, seizures.

Admitting Diagnosis Ms. Samuels was admitted to an acute medical unit with acute
pancreatitis. On admission she had an Ng tube inserted and was kept nothing by
mouth. She was started on the following IV. Normal saline, Bolas and electrolyte
replacement lactulos.

If she's kept nothing by mouth as her laculos by mouth, I guess maybe they would
change it to the Ng. Yeah. Fluorosimide Lasix 80 milligrams IV twice a day. Dietary
restrictions to protein and sodium intake with a high carbohydrate diet. It was
ordered for Ms.

Samuels which of the following best describes the pathophysiology of acute

pancreatitis, which of the following best describes the pathophysiology of acute
pancreatitis.