In a patient with suspected acute pancreatitis, serum lipase is measured rather than amylase. The primary reason lipase is preferred in this clinical setting is:

• A Lipase is not elevated in salivary gland disorders, making it 100% specific
• B Lipase has higher sensitivity at 2 hours compared to amylase
• C Lipase acts as a troponin-equivalent for pancreatic acinar cell death
• D Lipase remains elevated longer post-onset and is more specific for pancreatic injury ✓

Explanation

Serum lipase remains elevated for 7-14 days after acute pancreatitis onset, compared to amylase which normalises within 3-5 days, making lipase more useful when patients present late. Lipase is also more specific for the pancreas because salivary glands produce amylase but not lipase. The claim that lipase is 100% specific is false since it can be elevated in renal failure and intestinal injury. Higher 2-hour sensitivity over amylase is not established.

Reference: Harper's Illustrated Biochemistry, 32nd ed.

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Written and medically reviewed by the StethoPrep medical team.