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Severe acute pancreatitis — SCE Acute Medicine MCQ

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ModerateAcute GI PresentationsSevere acute pancreatitisSCE Acute Medicine

A 59-year-old man is assessed on the acute medical unit. He has pancreatitis with persistent hypotension, PaO2 7.9 kPa on oxygen and rising creatinine. Lactate is 4.8 mmol/L despite fluids. Initial assessment includes relevant observations, bedside tests and urgent blood results. What is the most appropriate next step in management?

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Correct answer: C — Request urgent senior critical care review

Request urgent senior critical care review is the best answer because organ failure in acute pancreatitis indicates severe disease needing critical care escalation. Arrange same-day ambulatory follow-up is plausible, but it is less appropriate for the physiology or timing described in this stem. The other distractors either fit a neighbouring presentation, delay definitive treatment, or miss the key immediate risk. Clinical pearl: Early aggressive but reassessed fluid therapy is important, but persistent organ failure changes setting of care.

Reference: https://www.nice.org.uk/guidance/ng104#acute-medicine-order-53-1