Gastroenterology and hepatology: hypertriglyceridaemic pancreatitis: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Gastroenterology and hepatology: hypertriglyceridaemic pancreatitis

Sample item

A 38-year-old man with poorly controlled diabetes has acute pancreatitis. His serum looks milky, there are no gallstones, he drinks no alcohol, and serum triglycerides are 2,400 mg/dL. Which specific therapy is appropriate?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Intravenous insulin infusion

Triglycerides above 1,000 mg/dL can cause pancreatitis by the release of toxic free fatty acids. Insulin infusion activates lipoprotein lipase and rapidly lowers triglycerides, and plasmapheresis is an alternative in severe cases. Long-term control with fibrates and diet prevents recurrence.

Option by option

  • A. Intravenous insulin infusion (correct)

    Correct. Insulin activates lipoprotein lipase and lowers triglycerides quickly.

  • B. Intravenous calcium gluconate

    Calcium gluconate is used for symptomatic hypocalcaemia and does not treat the cause.

  • C. Ursodeoxycholic acid

    Ursodeoxycholic acid dissolves cholesterol stones, which are not present.

  • D. Early ERCP

    Early ERCP is for gallstone pancreatitis with cholangitis, and none is suggested.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is A, Intravenous insulin infusion. Triglycerides above 1,000 mg/dL can cause pancreatitis by the release of toxic free fatty acids.

Why is "Intravenous calcium gluconate" not the answer?

Calcium gluconate is used for symptomatic hypocalcaemia and does not treat the cause.

Why is "Ursodeoxycholic acid" not the answer?

Ursodeoxycholic acid dissolves cholesterol stones, which are not present.

Why is "Early ERCP" not the answer?

Early ERCP is for gallstone pancreatitis with cholangitis, and none is suggested.

What concept does this question test?

It tests Gastroenterology and hepatology: hypertriglyceridaemic pancreatitis in General Medicine. Insulin infusion activates lipoprotein lipase and rapidly lowers triglycerides, and plasmapheresis is an alternative in severe cases. Long-term control with fibrates and diet prevents recurrence.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Gastroenterology and hepatology: hypertriglyceridaemic pancreatitis?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.