{"id":696,"date":"2021-10-27T01:48:00","date_gmt":"2021-10-27T01:48:00","guid":{"rendered":"https:\/\/www.osmosis.org\/blog\/?p=696"},"modified":"2025-10-01T11:40:35","modified_gmt":"2025-10-01T19:40:35","slug":"usmle-step-1-question-of-the-day-acute-pancreatitis","status":"publish","type":"post","link":"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-acute-pancreatitis","title":{"rendered":"USMLE\u00ae Step 1 Question of the Day: Acute Pancreatitis"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_80 ez-toc-wrap-center counter-hierarchy ez-toc-counter ez-toc-custom ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">In This Article<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-acute-pancreatitis\/#The_correct_answer_to_todays_USMLE%C2%AE_Step_1_Question_is%E2%80%A6\" >The correct answer to today&#8217;s USMLE\u00ae Step 1 Question is&#8230;<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-acute-pancreatitis\/#B_Serum_lipase_%3E_3_times_the_upper_limit_of_normal\" >B. Serum lipase &gt; 3 times the upper limit of normal<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-acute-pancreatitis\/#Incorrect_answer_explanations\" >Incorrect answer explanations<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-acute-pancreatitis\/#A_Serum_amylase_%3E_3_times_the_upper_limit_of_normal\" >A. Serum amylase &gt; 3 times the upper limit of normal<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-acute-pancreatitis\/#C_Serum_bilirubin_%3E_40_mgdL\" >C. Serum bilirubin &gt; 4.0 mg\/dL<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-acute-pancreatitis\/#D_Elevated_blood_alcohol_level\" >D. Elevated blood alcohol level<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-acute-pancreatitis\/#E_Blood_urea_nitrogen_BUN_level_%3E_22_mgdL\" >E. Blood urea nitrogen (BUN) level &gt; 22 mg\/dL<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-acute-pancreatitis\/#Main_Explanation\" >Main Explanation<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-acute-pancreatitis\/#Major_Takeaway\" >Major Takeaway<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-10\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-acute-pancreatitis\/#References\" >References<\/a><\/li><\/ul><\/nav><\/div>\n\n<p class=\"wp-block-paragraph\"><strong><em>Each week, Osmosis shares a USMLE\u00ae Step 1-style practice question to test your knowledge of medical topics. Today&#8217;s case involves a 44-year-old man with abdominal pain and nausea. Abdominal examination shows tenderness and rigidity over the epigastric and periumbilical regions.&nbsp;<\/em><\/strong><strong><em>Can you figure it out?<\/em><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A 44-year-old man comes to the emergency department with abdominal pain and nausea for the past 24 hours. The pain started a few hours after dinner, and he describes it as constant pain in the upper part of his abdomen that radiates to his back and flanks. The patient also reports nausea, intermittent vomiting, and abdominal distention. Family history is significant for recurrent episodes of pancreatitis in his father and paternal uncle. He reports drinking an average of 2 alcoholic drinks per week. His temperature is 37.7\u00baC (99.9\u00baF), pulse is 92\/min, respirations are 20\/min, peripheral oxygen saturation is 96%, and blood pressure is 149\/94 mmHg. He appears distressed and anxious. Abdominal examination shows tenderness and rigidity over the epigastric and periumbilical regions. Bowel sounds are diminished. No bruising of the umbilicus or flanks are seen. Which of the following laboratory results is the most specific in diagnosing this patient\u2019s condition?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>A. Serum amylase &gt; 3 times the upper limit of normal<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>B. Serum lipase &gt; 3 times the upper limit of normal<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>C. Serum bilirubin &gt; 4.0 mg\/dL<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>D. Elevated blood alcohol level<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>E. Blood urea nitrogen (BUN) level &gt; 22 mg\/dL<\/strong>Scroll down to find the answer!<\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-rich is-provider-embed-handler wp-block-embed-embed-handler wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"Everybody loves Osmosis.org\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/kizbJZ9cdLg?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><em><a href=\"https:\/\/www.osmosis.org\/plans\" target=\"_blank\" rel=\"noreferrer noopener\"><u><em><strong>\u2192 Reinforce your understanding with more self-assessment items on Osmosis.<\/strong>\u00a0<\/em><\/u><\/a><\/em><\/strong><\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"The_correct_answer_to_todays_USMLE%C2%AE_Step_1_Question_is%E2%80%A6\"><\/span>The correct answer to today&#8217;s USMLE\u00ae Step 1 Question is&#8230;<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"B_Serum_lipase_%3E_3_times_the_upper_limit_of_normal\"><\/span>B. Serum lipase &gt; 3 times the upper limit of normal<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Before we get to the&nbsp;<strong>Main Explanation<\/strong>, let&#8217;s look at the incorrect answer explanations. Skip to the bottom if you want to see the correct answer right away!<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Incorrect_answer_explanations\"><\/span>Incorrect answer explanations<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The incorrect answers to today&#8217;s USMLE\u00ae Step 1 Question are&#8230;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"A_Serum_amylase_%3E_3_times_the_upper_limit_of_normal\"><\/span>A. Serum amylase &gt; 3 times the upper limit of normal<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect<\/strong>: Although serum amylase elevation may be used to show biochemical evidence of acute pancreatitis, it is affected by serum pH, lipids, and bowel inflammation, and is prone to false elevations or spuriously normal results. Therefore it is not the most&nbsp;<em>specific<\/em>&nbsp;in diagnosing this patient\u2019s acute pancreatitis.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"C_Serum_bilirubin_%3E_40_mgdL\"><\/span>C. Serum bilirubin &gt; 4.0 mg\/dL<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect<\/strong>: Although hyperbilirubinemia may occur in up to 10% of patients with acute pancreatitis, bilirubin elevations are not specific to pancreatitis and do not contribute to the diagnosis. Serum bilirubin levels return to normal in 4-7 days.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"D_Elevated_blood_alcohol_level\"><\/span>D. Elevated blood alcohol level<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect<\/strong>: Although alcohol abuse may cause acute pancreatitis in a dose-dependent manner, this patient only consumes 2 beers\/week, which is unlikely to cause acute pancreatitis. Instead, his underlying familial&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Hypertriglyceridemia\" target=\"_blank\" rel=\"noreferrer noopener\">hypertriglyceridemia&nbsp;<\/a>is likely the cause of pancreatitis.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"E_Blood_urea_nitrogen_BUN_level_%3E_22_mgdL\"><\/span>E. Blood urea nitrogen (BUN) level &gt; 22 mg\/dL<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect<\/strong>: Azotemia (BUN &gt;22 mg\/dL) suggests more severe pancreatitis that is causing vascular permeability and intravascular volume depletion or hemorrhage. However, azotemia is not specific for acute pancreatitis and is not included in the diagnostic criteria.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"700\" height=\"250\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/usmle-step-1-everything-you-need-to-know-banner.png?w=700\" alt=\"Omosis ad\" class=\"wp-image-615\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/usmle-step-1-everything-you-need-to-know-banner.png 700w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/usmle-step-1-everything-you-need-to-know-banner.png?resize=300,107 300w\" sizes=\"auto, (max-width: 700px) 100vw, 700px\" \/><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Main_Explanation\"><\/span><strong>Main Explanation<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">This patient is presenting with constant abdominal<strong>&nbsp;pain&nbsp;<\/strong>localized in the&nbsp;<strong>epigastric region<\/strong>&nbsp;that radiates to the&nbsp;<strong>back<\/strong>, highly suggestive of&nbsp;<strong><a href=\"https:\/\/www.osmosis.org\/learn\/Acute_pancreatitis\" target=\"_blank\" rel=\"noreferrer noopener\">acute pancreatitis<\/a><\/strong>. Acute pancreatitis occurs when pancreatic enzymes are inappropriately activated, leading to tissue damage and an inflammatory response. This patient has a family history of recurrent pancreatitis in his father and paternal uncle, suggesting the diagnosis of&nbsp;<strong>familial hypertriglyceridemia<\/strong>, an&nbsp;<strong>autosomal dominant<\/strong>&nbsp;condition. The high concentration of serum triglycerides can cause acute pancreatitis because when pancreatic cells encounter triglycerides, they release lipase to break the triglycerides down into free fatty acids; excess free fatty acids can subsequently injure the pancreas.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The most common causes of pancreatitis are&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Gallstones\" target=\"_blank\" rel=\"noreferrer noopener\">gallstones&nbsp;<\/a>and alcohol toxicity. The other causes of pancreatitis can be easily remembered by the mnemonic&nbsp;<strong>\u201cI GET SMASHED\u201d<\/strong><\/p>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"605\" height=\"539\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/100.png\" alt=\"The most common causes of pancreatitis are\u00a0gallstones\u00a0and alcohol toxicity. The other causes of pancreatitis can be easily remembered by the mnemonic\" class=\"wp-image-700\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/100.png 605w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/100.png?resize=300,267 300w\" sizes=\"auto, (max-width: 605px) 100vw, 605px\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">To make a&nbsp;<strong>diagnosis of&nbsp;<\/strong><strong><a href=\"https:\/\/www.osmosis.org\/learn\/Acute_pancreatitis\" target=\"_blank\" rel=\"noreferrer noopener\">acute pancreatitis<\/a><\/strong>&nbsp;(from any cause), one needs&nbsp;<strong>2 out of 3<\/strong>&nbsp;of the following criteria:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>clinical symptoms<\/strong>, such as persistent, severe, epigastric pain with tenderness on palpation<\/li>\n\n\n\n<li><strong>laboratory<\/strong>&nbsp;studies demonstrating serum amylase or lipase greater than 3 times the upper limit of normal;&nbsp;<strong>lipase<\/strong>&nbsp;remains elevated for a longer period of time and has a&nbsp;<strong><a href=\"https:\/\/www.osmosis.org\/learn\/Sensitivity_and_specificity\" target=\"_blank\" rel=\"noreferrer noopener\">higher specificity<\/a><\/strong>&nbsp;as compared with amylase<\/li>\n\n\n\n<li><strong>imaging<\/strong>&nbsp;(computed tomography, magnetic resonance (MR), ultrasonography) showing focal or diffuse enlargement of the pancreas<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">In this patient with a characteristic clinical presentation, the demonstration of an elevated serum amylase or lipase level will confirm the diagnosis of acute pancreatitis. However, serum amylase may be spuriously normal in patients with hypertriglyceridemia and spuriously elevated in patients with acidemia (arterial pH \u2264 7.32), therefore&nbsp;<strong>serum lipase is the preferred laboratory test for diagnosing acute pancreatitis<\/strong>. It is important to note, however, that there is&nbsp;<strong>no correlation&nbsp;<\/strong>between the&nbsp;<em>severity<\/em>&nbsp;of pancreatitis and the degree of serum lipase and amylase elevations. Additionally, an elevation in serum triglyceride levels is not sufficient to diagnose acute pancreatitis.&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Hypertriglyceridemia\" target=\"_blank\" rel=\"noreferrer noopener\">Hyperbilirubinemia<\/a>, leukocytosis,&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Renal_azotemia\" target=\"_blank\" rel=\"noreferrer noopener\">azotemia<\/a>, and&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Hypoglycemics:_Insulin_secretagogues\" target=\"_blank\" rel=\"noreferrer noopener\">hypoglycemia&nbsp;<\/a>are suggestive of more severe disease, but are not themselves diagnostic of acute pancreatitis.<\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"Acute pancreatitis - an Osmosis Preview\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/XpAO_0-dTAQ?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><figcaption class=\"wp-element-caption\">What is acute pancreatitis? Acute pancreatitis describes a sudden inflammation of the pancreas, which can lead to a variety of severe complications.<\/figcaption><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Major_Takeaway\"><\/span><strong>Major Takeaway<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><a href=\"https:\/\/www.osmosis.org\/learn\/Acute_pancreatitis\" target=\"_blank\" rel=\"noreferrer noopener\">Acute pancreatitis<\/a><\/strong>&nbsp;is characterized by epigastric abdominal pain radiating to the back, often with nausea and vomiting. The diagnosis is made by meeting 2 of the 3 clinical, laboratory, and imaging criteria. The preferred diagnostic laboratory test for acute pancreatitis is a&nbsp;<strong>serum lipase greater than 3 times the upper limit of normal<\/strong>.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"References\"><\/span><strong>References<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Conwell, D. L., Banks, P. A., &amp; Greenberger, N. J. (2018). Acute and Chronic Pancreatitis. In J. L. Jameson, A. S. Fauci, D. L. Kasper, S. L. Hauser, D. L. Longo, &amp; J. Loscalzo (Eds.),&nbsp;<em>Harrison\u2019s Principles of Internal Medicine<\/em>&nbsp;(20th ed.). Retrieved from<a href=\"https:\/\/doi.org\/accessmedicine.mhmedical.com\/content.aspx?aid=1160016107\" target=\"_blank\" rel=\"noreferrer noopener\">&nbsp;accessmedicine.mhmedical.com\/content.aspx?aid=1160016107<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Toouli J, Brooke-Smith M, Bassi C, et al. Guidelines for the management of acute pancreatitis.&nbsp;<em>J Gastroenterol Hepatol<\/em>. 2002;17 Suppl:S15\u2010S39.&nbsp;<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/12000591\/\" target=\"_blank\" rel=\"noreferrer noopener\">doi:10.1046\/j.1440-1746.17.s1.2.x<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><em><strong>_________________________<\/strong><br><br><strong>Want more USMLE\u00ae Step 1 practice questions? Try Osmosis today! Access your&nbsp;<em><strong><a href=\"https:\/\/www.osmosis.org\/login?type=create\" target=\"_blank\" rel=\"noreferrer noopener\">free trial<\/a><\/strong><\/em>&nbsp;and find out why millions of current and future clinicians and caregivers love learning with us.<\/strong><\/em><\/p>\n\n\n\n<figure class=\"wp-block-image size-full\"><a href=\"https:\/\/www.osmosis.org\/login?type=create\"><img loading=\"lazy\" decoding=\"async\" width=\"700\" height=\"250\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/2024-09-02T195148.146.png\" alt=\"\" class=\"wp-image-701\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/2024-09-02T195148.146.png 700w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/2024-09-02T195148.146.png?resize=300,107 300w\" sizes=\"auto, (max-width: 700px) 100vw, 700px\" \/><\/a><\/figure>\n","protected":false},"excerpt":{"rendered":"<p>Each week, Osmosis shares a USMLE\u00ae Step 1-style practice question to test your knowledge of medical topics. Today&#8217;s case involves a 44-year-old man with abdominal pain and nausea. Abdominal examination shows tenderness and rigidity over the epigastric and periumbilical regions.&nbsp;Can you figure it out? A 44-year-old man comes to the emergency department with abdominal pain [&hellip;]<\/p>\n","protected":false},"author":202,"featured_media":698,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_post_was_ever_published":false},"categories":[27,20,1369,44],"tags":[],"class_list":["post-696","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medicine","category-exam-prep","category-step-1-questions","category-step-1"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.6 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>USMLE\u00ae Step 1 Question of the Day: Acute Pancreatitis - Osmosis Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-acute-pancreatitis\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"USMLE\u00ae Step 1 Question of the Day: Acute Pancreatitis - Osmosis Blog\" \/>\n<meta property=\"og:description\" content=\"Each week, Osmosis shares a USMLE\u00ae Step 1-style practice question to test your knowledge of medical topics. Today&#8217;s case involves a 44-year-old man with abdominal pain and nausea. Abdominal examination shows tenderness and rigidity over the epigastric and periumbilical regions.&nbsp;Can you figure it out? 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