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NBME 15 Answers

nbme15/Block 3/Question#6 (7.7 difficulty score)
A 45-year-old man has a 2-day history of ...
Action of pancreatic enzymes on adiposeπŸ”,πŸ“Ί
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 +7 
submitted by cassdawg(1377),

Based on the history (consumption of large amounts of alcohol and elevated serum amylase/lipase with hypocalcemia), this man likely has acute pancreatitis (FA2020 p397). One of the major complications is autodigestion of tissues, such as what is seen in the image.

cheesetouch  FA2018 P391 +  
epiglotitties  Can anyone explain/describe the image? I got it right based on the info from the question but would like to know anyways just for future reference +3  
randi  FA2019 391 It's also not alcoholic hepatitis because this "requires sustained, long term consumption" of alcohol and this patient consumption over the last few days. FA2019 395 +1  
whk123  Morphology to acute pancreatitis +1  
hecticsurreyguy  @epiglotitties this is purely a stab on my part but... I'm seeing variation in size and consistency of the adipocytes in the image, along with vesicular changes in several of the adipocytes in the bottom right hand corner of the figure. These would point towards lipolytic reaction being undergone in these adipocytes. +  



 +1 
submitted by cheesetouch(190),

Peripancreatic fat necrosis -> calcification of mesentery