American Board of Internal Medicine (ABIM) Certification Practice Exam

Which condition requires careful monitoring to prevent recurrent attacks post cholecystectomy?

1. Acute pancreatitis

2. Gastroesophageal reflux disease

3. Cholangitis

4. Diverticulitis

The correct answer is: Acute pancreatitis

Acute pancreatitis requires careful monitoring post cholecystectomy because there is a significant potential for recurrent episodes if the underlying causes are not managed properly. Cholecystectomy is often performed in cases where gallstones are the precipitating factor for acute pancreatitis. While the surgical removal of the gallbladder can alleviate the risk of stone-induced acute pancreatitis, patients still need close observation for other potential causes of pancreatitis, such as alcohol use and hypertriglyceridemia, among others. If these themes are not addressed, the patient remains susceptible to additional episodes. Gastroesophageal reflux disease, cholangitis, and diverticulitis, while they may have their own post-operative considerations, do not typically require the same level of careful monitoring for recurrent episodes directly related to the cholecystectomy. Instead, they are managed on a case-by-case basis according to their specific treatment protocols and risk factors.