A 57-year-old woman comes to the physician because of a 6-month history of weight loss, bloating, and diarrhea. She does not smoke or drink alcohol. The patient also experiences dull, epigastric abdominal pain that is exacerbated by eating and unrelieved by antacids. Her vital signs are within normal limits. She is 173 cm (5 ft 8 in) tall and weighs 54 kg (120 lb); BMI is 18 kg/m2. Sudan staining of a fecal specimen is positive, and fecal occult blood testing is negative. Blood testing reveals normal hemoglobin. Which of the following pathophysiologic changes are most likely present in this patient?

Question

A 57-year-old woman comes to the physician because of a 6-month history of weight loss, bloating, and diarrhea. She does not smoke or drink alcohol. The patient also experiences dull, epigastric abdominal pain that is exacerbated by eating and unrelieved by antacids. Her vital signs are within normal limits. She is 173 cm (5 ft 8 in) tall and weighs 54 kg (120 lb); BMI is 18 kg/m2. Sudan staining of a fecal specimen is positive, and fecal occult blood testing is negative.  Blood testing reveals normal hemoglobin.  Which of the following pathophysiologic changes are most likely present in this patient?

Quizplus · Accepted Answer

Eductional Objective: Chronic pancreatitis is an inflammatory disorder leading to pancreatic fibrosis and atrophy, resulting in endocrine (ie, insulin) and exocrine (eg, lipase, elastase, amylase, trypsin, chymotrypsin) insufficiencies.  Patients typically have postprandial steatorrhea (ie, bulky diarrhea that is difficult to flush) and epigastric pain with meals.  Low fecal elastase, positive Sudan staining, and elevated hemoglobin A1c support the diagnosis.

A 57-Year-Old Woman Comes to the Physician Because of a 6-Month