Question

All are factors of Ranson Scoring on admission except :

• A. \( \text{Serum urea} > 16\, \text{mmol/L} \)
• B. \( \text{White blood cell count} > 16 \times 10^{9}/\text{L} \)
• C. \( \text{Blood glucose} > 11.1\, \text{mmol/L} \, (> 200\, \text{mg/dL}) \)
• D. \( \text{Age} > 55\, \text{years} \)

Hint:

\textbf{Gastroenterology: Acute Pancreatitis Severity.} Ranson's criteria are a well-established tool for predicting the prognosis and severity of acute pancreatitis. Remember the specific parameters assessed at admission and during the first 48 hours.

Answer 1

The Correct Option is A

Ranson's criteria are used to assess the severity of acute pancreatitis. The factors assessed on admission include: \begin{itemize} \item Age \(> 55\) years \item White blood cell count \(> 16 \times 10^{9}/\text{L}\) \item Blood glucose \(> 11.1\, \text{mmol/L}\) (\(> 200\, \text{mg/dL}\)) \item Serum lactate dehydrogenase (LDH) \(> 350\, \text{IU/L}\) \item Aspartate aminotransferase (AST) \(> 250\, \text{IU/L}\) \end{itemize} Factors assessed during the initial 48 hours include: \begin{itemize} \item Hematocrit fall \(> 10\%\) \item Blood urea nitrogen (BUN) increase \(> 1.8\, \text{mmol/L}\) (\(> 5\, \text{mg/dL}\)) \item Serum calcium \(<2.0\, \text{mmol/L}\) (\(< 8\, \text{mg/dL}\)) \item Arterial PO\textsubscript{2} \(< 60\, \text{mmHg}\) \item Base deficit \(> 4\, \text{mmol/L}\) \item Estimated fluid sequestration \(> 6\, \text{L}\) \end{itemize} Looking at the options provided for admission criteria: \begin{itemize} \item Serum urea \(> 16\, \text{mmol/L}\) is related to the BUN increase during the initial 48 hours, not an admission criterion. \item White blood cell count \(> 16 \times 10^{9}/\text{L}\) is an admission criterion. \item Blood glucose \(> 11.1\, \text{mmol/L}\) (\(> 200\, \text{mg/dL}\)) is an admission criterion. \item Age \(> 55\) years is an admission criterion. \end{itemize} Therefore, Serum urea \(> 16\, \text{mmol/L}\) is NOT a factor of Ranson Scoring on admission.