mash
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A 55-year-old white woman has had recurrent episodes of alcohol-induced pancreatitis. Despite abstinence, the patient develops postprandial abdominal pain, bloating, weight loss despite good appetite, and bulky, foul-smelling stools. KUB shows pancreatic calcifications. Which of the following do you expect in this patient?
A. Diabetes mellitus
B. Malabsorption of fat-soluble vitamins D and K
C. Guaiac-positive stool
D. Courvoisier's sign
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| sanz
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B. Malabsorption
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| ELM
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D.
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| dev
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hi elm
why do u think the answer is D.it could be malabsorption na??
deepikamohan
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| SA
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she is lossing weigt but good appetiteand stool is more towards B.
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| noelle
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ITS CHRONIC PAN. SO MALABSORPTION N STUFF...
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| bluestar
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It's B. D is seen only in tumors but in this case,the weight loss is more likely due to malabsorption caused by pancreatitis.
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| lucky
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its b.
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| liiAmra
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It was mentioned that the pt has not eaten because of the pain...USMLE does not try to trick you like that to think of it as cancer just because the loss of weight. Answer is B.
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| ELM
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Mash where is the answer?
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| mash
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why not diabetes mellitus?
this pt most likely has chronic pancreatitis(hx of recurrent attacks of acute pancreatitis , steatorrhea and Xray finding of calcification)
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| ELM
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Mash, i was hoping that you have the answer. :lol: Guess not?
Well, to me she might have a cancer because of the weight loss and calcifications. A, B, D all can be right, depending on what the q writer wants :? so we have to try our lucks. I hate this type of qs.Hope we won't get too many qs like this.
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| mash
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ans is diabetes mellitus
Chronic pancreatitis is due to pancreatic damage from recurrent attacks of acute pancreatitis. The classic triad is abdominal pain, malabsorption, and diabetes mellitus. Twenty-five percent of cases are idiopathic. Vitamins D and K are absorbed intact from the intestine without digestion by lipase and are therefore absorbed normally in pancreatic insufficiency. Forty percent of patients, however, develop B12 deficiency.
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| ELM
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Very interesting, thanks Mash for the good q, keep posting more :lol: .
But how do they have def in absorbing B 12 in C.pancrititis though? To me all need for B 12 absorption is IFactor and intact iliem!!??
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