A 56-year-old male presents to the emergency department with severe epigastric pain radiating to his back. The pain started suddenly after a large meal the previous evening and is associated with nausea and vomiting. The patient has a history of alcohol use disorder, with daily alcohol consumption for the past 10 years. On examination, he appears distressed, with tenderness in the epigastrium and mild abdominal distension. His vital signs reveal a heart rate of 110 bpm and blood pressure of 95/60 mmHg. Initial laboratory tests are ordered and the patient is evaluated using Ranson’s criteria on admission. Which of the following parameters is part of Ranson’s criteria on admission?

A 45-year-old accountant was admitted to the hospital after experiencing severe abdominal pain for the past 24 hours. The pain, which he described as a constant, burning sensation in his upper abdomen, radiated to his back and was accompanied by nausea but no vomiting. He admitted to recent heavy alcohol consumption at a company retreat. His vital signs upon admission were notable for a fever of 38.5°C, heart rate of 110 bpm, and a blood pressure of 120/70 mmHg. His abdomen was tender on palpation, particularly in the epigastric area, with some guarding but no rebound tenderness. Laboratory tests showed significantly elevated levels of amylase and lipase, elevated liver enzymes, and an abdominal CT scan revealed inflammation and fluid accumulation in the pancreas. Which of the following is NOT part of the diagnostic criteria for acute pancreatitis?

Mr. James Smith, a 45-year-old accountant, was admitted to the hospital after experiencing severe abdominal pain for the past 24 hours. The pain, which he described as a constant, burning sensation in his upper abdomen, radiated to his back and was accompanied by nausea but no vomiting. He admitted to recent heavy alcohol consumption at a company retreat. His vital signs upon admission were notable for a fever of 38.5°C, heart rate of 110 bpm, and a blood pressure of 120/70 mmHg. His abdomen was tender on palpation, particularly in the epigastric area, with some guarding but no rebound tenderness. Laboratory tests showed significantly elevated levels of amylase and lipase, and an abdominal CT scan confirmed the diagnosis of acute pancreatitis. What is the first step in the management of acute pancreatitis?

A 50-year-old male presents to the emergency department with acute onset of severe epigastric pain radiating to the back, associated with nausea and vomiting. The pain began 8 hours ago, following a heavy meal and recent alcohol consumption. On examination, he is febrile (38°C) with epigastric tenderness. Laboratory investigations reveal elevated serum amylase and lipase levels, consistent with acute pancreatitis. Imaging is considered to confirm the diagnosis and assess for complications. What is the most commonly used imaging modality for the diagnosis of acute pancreatitis?

A 50-year-old male, presented to the emergency department with a chief complaint of severe abdominal pain. The pain was described as sharp, persistent, and localized to the upper abdomen with radiation to the back. It began abruptly 12 hours prior to his arrival, and had been steadily worsening. He reported feeling nauseous but had not vomited. Laboratory results confirmed the clinical suspicion with elevated levels of amylase at 450 U/L and lipase at 600 U/L, both indicative of pancreatic inflammation. Which of the following criteria is used to assess the severity of acute pancreatitis?

Maria, a 44-year-old woman with a history of paroxysmal nocturnal hemoglobinuria (PNH) and chronic alcohol use, presents with severe abdominal pain, abdominal distention, and shortness of breath that have progressively worsened over the past week. She reports episodes of vomiting but denies changes in bowel habits or stool color. She has a significant history of three hospital admissions for hepatic vein thrombosis in the last 12 months. She also takes daily oral contraceptives and mentions that her sister developed deep vein thrombosis at the age of 48 years. On examination, Maria has mild jaundice, a protuberant abdomen with a fluid wave, and right upper quadrant tenderness with hepatomegaly extending 7 cm below the costal margin. Prominent dilated veins are visible on her abdomen and back when standing, along with moderate ascites and bilateral pitting edema. Her vital signs show tachycardia and mild hypotension. Given her history of recurrent hepatic vein thrombosis, a thorough evaluation for underlying causes is initiated. What is the next best diagnostic evaluation in the management of this patient?