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Acute pancreatitis — MCCQE Part 1 MCQ

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HardAbdominal PainAcute pancreatitisMCCQE Part 1

A 43-year-old man presents with severe epigastric pain radiating to the back after heavy alcohol intake. Lipase is more than three times the upper limit of normal, oxygen saturation is 96%, creatinine is normal, and ultrasound shows no gallstones. He asks whether antibiotics or a procedure will speed recovery. What should you tell this patient?

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Correct answer: B — Treatment is mainly fluids, analgesia, and early feeding as tolerated

Uncomplicated acute pancreatitis is treated supportively with fluids, analgesia, antiemetics, and nutrition as tolerated. Prophylactic antibiotics do not improve outcomes without infected necrosis or another infection. ERCP is reserved for cholangitis or persistent biliary obstruction, not typical alcohol-related pancreatitis without obstruction. The key counselling point is close monitoring for complications while avoiding low-value interventions.

Reference: Canadian clinical practice guideline for acute pancreatitis