Which of the following enzymes disturbances are seen in pancreatic disorders (e.g., acute pancreatitis)?

1. Increased Amylase

2. Increased Lipase

3. Decreased Trypsin

4. Increased lactose,

Choose the most appropriate answer?

1. A

   1 and 2

2. B

   3 only

3. C

   2 and 3

4. D

   1, 2 and 3

Appeared in: NORCET 9 Mains - 2025

Explanation

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• Acute pancreatitis involves inflammation and autodigestion of the pancreas, causing enzymes to leak into the bloodstream.
• Serum amylase and lipase are the primary enzymes measured to diagnose acute pancreatitis.
• Both amylase and lipase levels are significantly increased during an acute episode.
• Lipase is considered more specific than amylase for pancreatic damage and remains elevated for a longer duration.

Why Other Options Were Wrong

• Option B: This option is incorrect because it only includes statement 3, which is false. In acute pancreatitis, serum trypsin levels are increased due to leakage from the inflamed pancreas, not decreased.
• Option C: This option is incorrect because it includes statement 3 (Decreased Trypsin), which is factually wrong for acute pancreatitis. While statement 2 (Increased Lipase) is correct, the combination is invalid.
• Option D: This option is incorrect because it includes the false statement 3 (Decreased Trypsin). Although statements 1 and 2 are correct, the inclusion of an incorrect statement makes the entire option wrong.

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Clinical Relevance

• Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Diagnostic enzyme markers for acute pancreatitis as background academic context rather than a clinical decision trigger.
• Nurses must be able to interpret lab results for amylase and lipase to identify and monitor patients with acute pancreatitis.
• The triad of symptoms for acute pancreatitis diagnosis is: 1) characteristic abdominal pain, 2) serum amylase or lipase levels at least three times the upper limit of normal, and 3) characteristic findings on imaging. Two of these three are required.
• Understanding that lipase is more specific helps in differentiating pancreatic issues from other causes of hyperamylasemia (e.g., salivary gland issues, renal failure).

How to Approach the Question

• First, identify the core of the question: which enzyme changes occur in acute pancreatitis?
• Evaluate each numbered statement individually based on your knowledge of pancreatic pathophysiology.
• Statement 1: Increased Amylase. Recall that amylase is a key marker for pancreatitis. This is likely true.
• Statement 2: Increased Lipase. Recall that lipase is another, more specific, marker for pancreatitis. This is also likely true.
• Statement 3: Decreased Trypsin. Think about the mechanism. In acute inflammation, enzymes leak out, so levels in the blood should rise. Decreased production is a feature of chronic, not acute, disease. This statement is likely false.
• Statement 4: Increased lactose. Lactose is a sugar, not a pancreatic enzyme. This is irrelevant. This statement is false.

Concept Tested & Keywords

• Concept Tested: Diagnostic enzyme markers for acute pancreatitis
• Stem keywords: enzyme disturbances, pancreatic disorders, acute pancreatitis
• Lead-in keywords: Which of the following, Choose the most appropriate answer
• Negative lead-in flag: false

Question ID

QPn_z34jAn1hs16V58LzRl

Copy ID

Reference Book

E6 Textbook of Biochemistry for medical StudentsDM Vasudevan Part 2 — Subpart A (pp 1-239 of 478) p. 40-42

E6 Medicine Harrison 22e Part 2 p. 644-646