<prompt> 35-year-old man presenting with acute pancreatitis- Ideal fluid of choiceIsotonic crystalloidHypertonic crystalloidsHypotonic crystalloidVasopressin  <response>: Ans. a Isotonic CrystalloidRef: Sabiston 20th ed; pg. 1528Management of Acute pancreatitis: Corner stone of medical management is resuscitation with IV fluids - ISOTONIC CRYSTALLOIDS are given aggressively. Monitor the adequacy of resuscitation with urine output. If there is no response to fluid resuscitation - Invasive monitoring to be done using CVP access and Foley catheterization. MC complication in acute pancreatitis is Hypoxemia due to Acute lung injury and hence maintain Saturation above 95- Continuous Pulse oximetry monitoring is needed. Preferred analgesia- morphine narcotics No proven benefit of giving Antiproteases and Pancreas secretion inhibitors or platelet activation inhibitors Lexipafant.Nutritional Support in Acute Pancreatitis: Oral feeding may be difficult because of Ileus, pain and intubation. 20 of severe acute pancreatitis will develop severe pain on oral feeding. Enteral or Parenteral must be given though the mortality rate is same in both. Enteral nutrition has one advantage - less infectious complication. TPN causes Intestinal Colonization of bacteria, translocation and damage of mucosal defense mechanism. Hence whenever possible give Enteral Nasogastric feeding is better as per Bailey and Love page 122527th edition Prophylactic antibiotics have no role in acute pancreatitis and indicated only for pancreatic abscess, infected necrosis, cholangitis.Additional treatments: If it is a case of Gallstone pancreatitis caused by Stones in CBD causing Cholangitis, Jaundice- ERCP must be done in 72 hours time as per Bailey and Love. Mild Acute Pancreatitis caused by Gallstones - EARLY laparoscopic Cholecystectomy During same admission is indicated except in poor performance cases like old age. Severe Acute pancreatitis caused by Gall stones - conservative treatment for 6 weeks followed by Interval cholecystectomy after 6 weeks is advised. 