Which of the following are included in Ranson scoring system to predict the severity of acute pancreatitis at the time of admission?
1. $\text{WBC count} > 15 \times 10^8/L$
2. $\text{Blood glucose} > 200 \text{mg}/dL$
3. $LDH > 350 \text{units/L}$
4. $AST > 250 \text{units/L}$
Select the correct answer using the code given below.
Ranson Criteria for Acute Pancreatitis at Admission
The Ranson scoring system uses five parameters assessed at the time of admission to predict the severity of acute pancreatitis: age > 55 years, WBC count > 16,000/mm³, blood glucose > 200 mg/dL, serum LDH > 350 IU/L, and serum AST (SGOT) > 250 IU/L. The correct answer is 2, 3 and 4.
Analysis of Each Option
- Item 1 (WBC count > 15 × 108/L): This is incorrect. The actual Ranson admission criterion for WBC is > 16,000 cells/mm³ (i.e., 16 × 109/L), not > 15 × 108/L. The value and unit given in this option do not match the standard cutoff used in the Ranson criteria, so this item is not one of the admission parameters.
- Item 2 (Blood glucose > 200 mg/dL): This is correct. Hyperglycemia above 200 mg/dL at admission is one of the five official Ranson admission criteria, reflecting stress-induced insulin resistance and pancreatic islet cell dysfunction.
- Item 3 (LDH > 350 units/L): This is correct. An elevated serum LDH above 350 IU/L at admission is a recognized Ranson criterion, indicating tissue necrosis and cellular injury.
- Item 4 (AST > 250 units/L): This is correct. Serum AST (SGOT) > 250 IU/L at admission is one of the five Ranson admission parameters, reflecting hepatocellular/pancreatic tissue damage and biliary involvement.
Why the Other Options Are Wrong
- Options containing Item 1 (1, 2 and 3; 1, 3 and 4; 1, 2 and 4) are incorrect because Item 1, as worded, does not correspond to the actual Ranson admission WBC criterion (> 16,000/mm³); the value/unit stated (> 15 × 108/L) is not part of the validated scoring system.
Conclusion
The three parameters that genuinely correspond to Ranson's admission criteria among the given items are blood glucose > 200 mg/dL, LDH > 350 units/L, and AST > 250 units/L — i.e., items 2, 3 and 4. Hence, option "2, 3 and 4" is the correct answer.
Important Questions from Hepatobiliary & Pancreatic Surgery
- Which of the statements regarding Calot's triangle are correct?
1. Common hepatic duct forms the medial boundary of the Calot's triangle
2. Inferior surface of the right lobe of the liver forms the superior boundary of Calot's triangle
3. Right hepatic artery is usually found as a content of the Calot's triangle
4. Cystic duct and medial border of gall bladder forms the lateral border of Calot's triangle
Select the correct answer using the code given below: - CA 19-9 is a tumour marker used for the diagnosis of:
- The Model for End Stage Liver Disease (MELD) score includes which of the following variables ?
1. Serum bilirubin
2. Serum albumin
3. Serum creatinine
4. International Normalised Ratio (INR)
Select the correct answer using the code given below : - Which of the following are options for management of a pancreatic pseu- docyst?
1. Pancreaticoduodenectomy
2. Cystogastrostomy
3. Percutaneous drainage
4. Endoscopic drainage
Select the correct answer using the code given below : - Which of the following statements regarding hepatic adenomas are correct?
1. They are almost exclusively seen in females aged 25-50 years
2. They are associated with use of oral contraceptive pills
3. They do not have any malignant potential
4. Majority are detected incidentally on imaging
Select the correct answer using the code given below :
