Inflammatory Bowel Disease USMLE Step 1 Practice Question
A 49-year-old man with a 20-year history of heavy alcohol use presents with chronic epigastric pain, greasy foul-smelling stools, and 8-kg weight loss over 6 months. Vital signs show BP 128/82, HR 92, RR 16, temp 37.2°C, SpO2 98%. Laboratory studies reveal fecal elastase of 180 μg/g (markedly reduced) and elevated liver enzymes. Abdominal ultrasound shows pancreatic atrophy. He denies recent fever. Which of the following is the most likely diagnosis?
Answer choices
- ACrohn disease of the terminal ileum
- BCeliac disease
- CExocrine pancreatic insufficiency from chronic pancreatitisCorrect answer
- DUlcerative colitis
- ELactase deficiency
- FPancreatic cancer with metastatic involvement
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