Question

The nurse is providing care for a client with possible pancreatic cancer. Which test is the most definitive diagnostic exam for this type of cancer? A. Serum amylase B. Pancreatic ultrasonography C. CT scan D. ERCP with cytologies

Short answer

Answer: D. ERCP with cytologies

Step-by-step solution

Analyze the options

In this step, we'll briefly discuss each option and its relevance to pancreatic cancer diagnosis, so that we can make better decisions in subsequent steps. A. Serum amylase: Serum amylase is an enzyme primarily produced by the pancreas, and testing its levels is often used to determine if there's a problem with the pancreas. However, increased serum amylase levels can also indicate other conditions, such as pancreatitis. B. Pancreatic ultrasonography: This is a non-invasive imaging technique that uses sound waves to visualize the pancreas. It can help to detect abnormal growths or masses in the pancreas, but it may not provide definitive information about cancer. C. CT scan: A computed tomography (CT) scan is an imaging test that creates detailed cross-sectional images of the body, including the pancreas. It can reveal abnormal growths or masses, which may suggest cancer. However, it cannot definitively diagnose cancer by itself, as benign conditions can also cause abnormal growths. D. ERCP with cytologies: Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure that uses an endoscope to examine and access the bile ducts, pancreatic ducts, and the surrounding area. Tissue samples or cell scrapings (cytologies) can be collected during ERCP. These samples can be analyzed to determine if cancer cells are present, thus providing a more definitive diagnosis.

Compare and identify the most definitive test

Now that we have analyzed all the options, we'll compare their relevance to diagnosing pancreatic cancer and identify the most definitive test among them. As mentioned earlier, serum amylase levels can be increased due to various reasons and are not specific to pancreatic cancer. Ultrasonography and CT scans can identify abnormal growths or masses but cannot differentiate cancerous cells from benign conditions. ERCP with cytologies, however, allows for the examination and collection of tissue samples or cell scrapings. The analysis of these samples can provide definitive information about the presence of cancer cells. Therefore, among the provided options, ERCP with cytologies is the most definitive diagnostic exam for pancreatic cancer.

Conclusion

After analyzing and comparing all the options, we conclude that the most definitive diagnostic exam for pancreatic cancer is: D. ERCP with cytologies