This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: G.I.T, Subject name: Anatomy
True about acute pancreatitis All/Except - 
Select and explain. 
A. Gallstones & alcohol are common, B. Sr. amylase levels increase after 72 hrs. of attack, C. Can cause secondary pleural effusion, D. Can present with shock
B: Sr. amylase levels increase after 72 hrs. of attack
Answer: B: Sr. amylase levels increase after 72 hrs. of attack 
Explanation: Serum amylase concentration increases almost immediately with the onset of disease and peaks within several hours. It remains elevated for 48 to 72 hrs after which it stas decreasing and return to normal levels within 3 to 5 days. Pleural effusion can be seen in about 10% of cases. It is usually left sided. Shock is not unusual and may result from hypovolemia sec. to exudation of blood & plasma proteins into the retroperitoneal space. increased formation of kinin peptides which cause vasodilatation and increased vascular permeability. systemic effects of proteolytic and lipolytic enzymes released into the circulation. Ref : Schwaz 9/e p1181