The cautious doctor (300)

As you go to the store room to collect the paracetamol, you bump in to the nurse who initially spoke to Sally. The nurse tells you that Sally’s pain needs more than paracetamol, and she’d benefit from an opioid, like pethidine. You realise the nurse is right, and so you collect 75mg of IM pethidine, before going and letting Sally know that you will be administering a stronger analgesia for her pain.

Thank god for nurses… keeping the F1’s in check.

The analgesia was a miracle, as Sally can finally speak to you – she tells you her history of severe and sharp epigastric pain which began 12 hours ago, which radiates to her back, and is associated with nausea. 

Along with the previous blood tests and observations, which test is likely to confirm Sally’s diagnosis?

Liver function tests

Serum amylase

Abdominal xray