Hepatobiliary and pancreatic surgery: exocrine insufficiency in chronic pancreatitis: practice question

A General Surgery 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.

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General Surgery · Hepatobiliary and pancreatic surgery: exocrine insufficiency in chronic pancreatitis

Sample item

A 45-year-old man with long-standing alcohol-related chronic pancreatitis passes pale, bulky, foul-smelling stools that float and has lost weight. What is the most appropriate treatment of the stool abnormality?

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

The answer and the reasoning

B. Enteric-coated pancreatic enzymes with meals

Fat malabsorption in chronic pancreatitis results from lipase deficiency. Treatment is pancreatic enzyme replacement taken with food, with an acid suppressant if required to protect the enzymes, along with fat-soluble vitamin supplementation.

Option by option

  • A. Cholestyramine with meals

    Cholestyramine binds bile acids and treats bile-acid diarrhoea, not lipase deficiency.

  • B. Enteric-coated pancreatic enzymes with meals (correct)

    Correct. Enzyme replacement corrects the lipase deficiency that causes steatorrhoea.

  • C. Ursodeoxycholic acid

    Ursodeoxycholic acid is used in cholestatic liver disease and gallstone dissolution.

  • D. Octreotide injections

    Octreotide reduces secretions and does not replace enzymes.

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.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is B, Enteric-coated pancreatic enzymes with meals. Fat malabsorption in chronic pancreatitis results from lipase deficiency.

Why is "Cholestyramine with meals" not the answer?

Cholestyramine binds bile acids and treats bile-acid diarrhoea, not lipase deficiency.

Why is "Ursodeoxycholic acid" not the answer?

Ursodeoxycholic acid is used in cholestatic liver disease and gallstone dissolution.

Why is "Octreotide injections" not the answer?

Octreotide reduces secretions and does not replace enzymes.

What concept does this question test?

It tests Hepatobiliary and pancreatic surgery: exocrine insufficiency in chronic pancreatitis in General Surgery. Treatment is pancreatic enzyme replacement taken with food, with an acid suppressant if required to protect the enzymes, along with fat-soluble vitamin supplementation.

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 Hepatobiliary and pancreatic surgery: exocrine insufficiency in chronic pancreatitis?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery 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.