MSRA-0767

MSRA-0767

A 35-year-old woman presents with epigastric pain which radiates to the back. She feels nauseous and has been vomiting since arriving at the Emergency Department. On questioning, the woman tells you that she takes no regular medication. She was last in hospital three years ago after she slipped and fell in the shower. She was not admitted. She travelled to Thailand to visit relatives two months ago.
On examination, the woman’s abdomen is tender in the epigastrium. She is jaundiced. She is also tachycardia and pyrexia.
Investigations reveal the following:
Investigation Result Normal
Alkaline phosphatase (ALP) 280 IU 30–130 IU
Alanine aminotransferase (ALT) 50 IU 5–30 IU
Bilirubin 40 µmol/l 2–17 µmol/l
Amylase 900 u/l 30-100 u/l
What is the best initial treatment for this woman?