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NBME 24 Answers

nbme24/Block 1/Question#23 (23.3 difficulty score)
A 50-year-old man comes to the physician ...
Generalized malabsorption🔍

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 +7  upvote downvote
submitted by karljeon(89),
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A anm ihtw a Hx of HEOt deencdnepe nda cniocrh adb aipn as llwe as ayX-r ngidnfsi of ica"itscfilonac in hte -rpiumpde n"dombea is tsom kyleli grrirnfee ot a iccrhno i.cnarispeatt

shTi lsead to a kcla of pseail ensoceirt nc,ehe ,pela mosll-eigfnul ssolot hitw iol lrspdeto rep tp x.H siTh tps' epcrnasa asol dseo'nt serecte threo ,eszynme chus as syalea,ms eopse,tsra nro iysnptgrneo ot( vieaattc toreh zne,m)sye os eth rwnaes is rzieegadle"n rpam"

karljeon  p. 367 (FA 2018) +6  
usmlecrasherss  pancreatic insufficiency FA 2019 p375 , +1  
almondbreeze  FA 2019 p391 on chronic pancreatitis +  
almondbreeze  UW: in chronic alcoholic pancreatitis, alcohol induced secretion of protein rich fluid precipitates in pancreatic duct--> forms ductal plugs that calcify +2  

 +3  upvote downvote
submitted by hungrybox(791),

(D) Portal hypertension: Portal hypertension is a complication of longstanding alcoholism, but it is not the cause of acute or chronic pancreatitis.

In acute pancreatitis, alcohol transiently increases pancreatic exocrine secretion and contraction of the sphincter of Oddi (the muscle regulating the flow of pancreatic juice through papilla of Vater).

This leads to activation of pancreatic enzymes and acute pancreatitis follows soon after.

In chronic pancreatitis (as in this patient), alcohol increases the protein concentration of pancreatic secretions, and this protein-rich pancreatic fluid can form ductal plugs.

Made this explanation in case any of you were dumb enough to think "pancreatitis → alcohol → portal hypertension" like me.

hungrybox  oh my source was big robbins btw +  
regularstudent  I was definitely dumb enough +  

F**K this question!

Know exactly what the disease is without knowing what the f**king "generalized malabsorption" means!!

tiredofstudying  Hope your day got a little better after this +5