A patient admitted with acute pancreatitis is being assessed for severity using the Glasgow (Imrie) criteria.
Which of the following is NOT part of the Glasgow criteria?
A
Albumin
B
CRP
C
Arterial blood gas
D
Calcium
E
LDH
Decoding the Stem
1
CLUE
"Glasgow criteria parameters"
TRANSLATION
Recall PANCREAS mnemonic.
Explanation
B. CRP: ✅ Correct. While CRP is a valuable individual marker of severity (>150 mg/L at 48h), it is not one of the 8 parameters of the Glasgow (Imrie) score.
Glasgow "PANCREAS" Mnemonic:
- P - PaO₂ < 8 kPa (60 mmHg)
- A - Age > 55 years
- N - Neutrophils (WBC > 15 x 10⁹/L)
- C - Calcium < 2 mmol/L
- R - Renal function (Urea > 16 mmol/L)
- E - Enzymes (LDH > 600 U/L or AST > 200 U/L)
- A - Albumin < 32 g/L
- S - Sugar (Glucose > 10 mmol/L)
A, C, D, E: ❌ These are all included in the "PANCREAS" mnemonic used for Glasgow scoring.
🧠High-Yield Pearls
✔ Glasgow criteria applies to both gallstone & alcoholic pancreatitis.
✔ CRP >150 mg/L at 48 hours is the most sensitive individual marker of severity.
✔ Severity: ≥3 criteria = severe pancreatitis.
Integrated Clinical Questions
1. Glasgow vs Ranson difference?
Answer: Glasgow is simpler and works for all causes; Ranson has separate criteria for alcoholic vs gallstone pancreatitis.
2. Most sensitive marker of severity (clinically)?
Answer: CRP > 150 mg/L at 48 hours.
3. Why does hypoxia occur?
Answer: Development of ARDS due to systemic inflammation and capillary leak.
4. Most important initial step?
Answer: Aggressive IV fluid resuscitation.
5. When to suspect severe pancreatitis?
Answer: Presence of organ failure (shock, ARDS, renal failure), high scoring systems (≥3), or systemic signs of toxicity.
⚡ Exam Pearls
- CRP = important but NOT in Glasgow.
- Remember the PANCREAS mnemonic.
- Common trap: Confusing scoring parameters with individual biomarkers like CRP or Lipase.
FreeMedSite • Open Medical Education
0 Comments