A 49-year-old man presents with severe epigastric pain radiating to the back after heavy alcohol intake. Serum amylase and lipase are markedly elevate...

Question

A 49-year-old man presents with severe epigastric pain radiating to the back after heavy alcohol intake. Serum amylase and lipase are markedly elevated. He is hypotensive and tachycardic. Which initial management step is most important in the first 24 hours?

Accepted Answer

Early aggressive IV fluid resuscitation with isotonic crystalloid

Answer

Routine prophylactic broad-spectrum antibiotics

Answer

Immediate ERCP in all patients

Answer

Early enteral nutrition via nasojejunal tube within 2 hours

Answer

Elective cholecystectomy during this admission

ca-mccqe1 MCQ (SBA): Acute pancreatitis

A 49-year-old man presents with severe epigastric pain radiating to the back after heavy alcohol intake. Serum amylase and lipase are markedly elevated. He is hypotensive and tachycardic. Which initial management step is most important in the first 24 hours?