This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Surgery
[{'content': 'Serum amylase level is increased in all of the following except: March 2005 \nSelect and explain. \nA. Intestinal obstruction, B. Perforated ulcer, C. Acute pancreatitis, D. Acute appendicitis', 'role': 'user'}, {'content': 'Answer: D \nExplanation: Ans. D: Acute appendicitis Increased amylase levels may indicate: - Acute pancreatitis - Cancer of the pancreas, ovaries, or lungs - Cholecystitis - Infection of the salivary glands (such as mumps) or an obstruction - Intestinal obstruction - Macroamylasemia Pancreatic or bile duct obstruction - Perforated ulcer - Tubal pregnancy (may be ruptured) - Viral gastroenteritis Decreased amylase levels may indicate: - Damage to the pancreas - Kidney disease - Pancreatic cancer - Toxemia of pregnancy Drugs that can increase amylase measurements include: - Asparaginase - Aspirin Bih control pills - Cholinergic medications - Coicosteroids - Indomethacin - Loop and thiazide diuretics - Methyldopa - Opiates (codeine, morphine) - Pentazocine', 'role': 'assistant'}]