Gastroenterology: chronic pancreatitis and steatorrhoea: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

General Medicine · Gastroenterology: chronic pancreatitis and steatorrhoea

Sample item

A 45-year-old man with long-standing alcohol-related chronic pancreatitis and pancreatic calcification has weight loss and pale, bulky, foul-smelling stools. He has stopped drinking and his pain is controlled. Which treatment best addresses his steatorrhoea?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Pancreatic enzyme capsules taken with meals

Fat malabsorption appears when lipase output falls to under about 10% of normal. Enteric-coated pancreatic enzyme preparations taken with meals replace lipase, and a proton pump inhibitor can be added if the response is poor because acid inactivates the enzyme. Fat-soluble vitamins and diabetes must also be monitored.

Option by option

  • A. Subcutaneous octreotide injections

    Octreotide reduces secretion and does not treat pancreatic exocrine insufficiency.

  • B. A short course of oral prednisolone

    Prednisolone treats autoimmune (IgG4-related) pancreatitis, not calcific alcohol-related disease.

  • C. Pancreatic enzyme capsules taken with meals (correct)

    Enzyme replacement taken with food restores fat digestion and reduces steatorrhoea.

  • D. Cholestyramine taken with meals

    Cholestyramine binds bile acids and treats bile acid diarrhoea but may worsen fat malabsorption.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is C, Pancreatic enzyme capsules taken with meals. Fat malabsorption appears when lipase output falls to under about 10% of normal.

Why is "Subcutaneous octreotide injections" not the answer?

Octreotide reduces secretion and does not treat pancreatic exocrine insufficiency.

Why is "A short course of oral prednisolone" not the answer?

Prednisolone treats autoimmune (IgG4-related) pancreatitis, not calcific alcohol-related disease.

Why is "Cholestyramine taken with meals" not the answer?

Cholestyramine binds bile acids and treats bile acid diarrhoea but may worsen fat malabsorption.

What concept does this question test?

It tests Gastroenterology: chronic pancreatitis and steatorrhoea in General Medicine. Enteric-coated pancreatic enzyme preparations taken with meals replace lipase, and a proton pump inhibitor can be added if the response is poor because acid inactivates the enzyme. Fat-soluble vitamins and diabetes must also be monitored.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Gastroenterology: chronic pancreatitis and steatorrhoea?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.