Card 25 / 34: A 42 year old woman has had intermittent episodes of right upper quadrant abdominal pain that begin 1-2 hours after eating. The pain resolves after 3-4 hours. She comes to the emergency room with severe peri-umbilical pain. Her amylase and lipase are elevated and a right upper quadrant ultrasound shows sludge. Which of the following best explains the pathogenesis of her condition?
1.) Activation of pancreatic enzymes within the duodenal lumen
2.) Temporary blockage of the exit of enzyme granules from acinar cells
3.) Proteinaceous plugs in pancreatic ducts
4.) Activation of pancreatic enzymes within the bile duct
5.) Pancreatic duct stricture

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