ROSH Gastrointestinal Practice Exam

Which condition may present with steatorrhea and significant weight loss as key symptoms?

1. Gastroesophageal reflux disease

2. Cholecystitis

3. Pancreatic insufficiency

4. Functional dyspepsia

The correct answer is: Pancreatic insufficiency

The presence of steatorrhea and significant weight loss as key symptoms directly points toward pancreatic insufficiency. In this condition, the pancreas fails to produce enough digestive enzymes, which are crucial for breaking down fats, proteins, and carbohydrates. This inadequacy in enzyme production leads to malabsorption, where dietary fats are not properly digested and absorbed, resulting in steatorrhea, characterized by greasy, foul-smelling stools. Additionally, malabsorption can lead to significant weight loss, as the body is unable to utilize the nutrients consumed. In contrast, the other conditions listed do not typically result in steatorrhea. Gastroesophageal reflux disease primarily presents with symptoms related to acid reflux such as heartburn and regurgitation, rather than malabsorption. Cholecystitis involves inflammation of the gallbladder, which may cause abdominal pain but is less associated with steatorrhea or notable weight loss. Functional dyspepsia presents with symptoms like bloating or discomfort without identifying a clear structural or biochemical issue, and while it can lead to weight loss due to eating avoidance, it does not produce steatorrhea. Thus, pancreatic insufficiency stands out as the condition most closely associated with the outlined symptoms.