American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the primary condition linked to steatorrhea?

1. Esophageal varices

2. Pancreatic insufficiency

3. Scleroderma

4. Hormone-producing tumors

The correct answer is: Pancreatic insufficiency

Steatorrhea, which is characterized by the presence of excess fat in the stool, is primarily linked to pancreatic insufficiency. The pancreas plays a crucial role in digestion by producing enzymes necessary for breaking down fats, proteins, and carbohydrates. When the pancreas fails to produce an adequate amount of these digestive enzymes, as seen in conditions such as chronic pancreatitis or cystic fibrosis, the body is unable to effectively digest and absorb dietary fats. This leads to the malabsorption of fats, resulting in steatorrhea. In the context of the other conditions mentioned, esophageal varices primarily relate to liver dysfunction and portal hypertension, which do not directly affect fat digestion. Scleroderma can lead to gastrointestinal issues, but it does not directly cause the fat malabsorption associated with steatorrhea. Hormone-producing tumors may alter metabolism or digestive processes but are not a primary cause of fat malabsorption. Therefore, pancreatic insufficiency is clearly the most relevant and direct condition associated with steatorrhea.