American Board of Internal Medicine (ABIM) Certification Practice Exam

What is one common cause of steatorrhea?

1. Infections

2. Pancreatic insufficiency

3. Medication side effects

4. Hormone-producing tumors

The correct answer is: Pancreatic insufficiency

Steatorrhea is characterized by the presence of excessive fat in the stool, leading to bulky, pale, and foul-smelling feces. One common cause of steatorrhea is pancreatic insufficiency, which occurs when the pancreas does not produce enough digestive enzymes, particularly lipases. These enzymes are essential for the breakdown of fats in the diet. When pancreatic insufficiency occurs, the digestion and absorption of dietary fats are impaired, leading to the malabsorption of fat, which then appears in the stool as steatorrhea. Conditions leading to pancreatic insufficiency include chronic pancreatitis, cystic fibrosis, and pancreatic cancer. Other potential causes of steatorrhea, such as infections, medication side effects, and hormone-producing tumors, can contribute to varied gastrointestinal symptoms but are less directly related to the fat absorption process than pancreatic insufficiency. Infections may affect the intestines and cause diarrhea, while certain medications may alter intestinal function or digestion, but neither is as closely associated with the specific problem of fat malabsorption seen in pancreatic insufficiency. Hormone-producing tumors may cause changes in motility or secretion but generally do not lead directly to steatorrhea in the same way that pancreatic enzyme deficiencies do.