Case 3 question 2

Try again! While the patient is at risk for C difficile infection with recent hospitalization and antibiotic use, he should not be empirically treated for C diff infection without prior testing.

Correct! Recurrent acute pancreatitis, can result in exocrine pancreatic insufficiency. The risk increases in patients with alcohol as the etiology, pancreatic necrosis, disrupted pancreatic duct and patients with a history of necrosectomy. Due to decreased pancreatic lipase production, there is malabsorption of fats, resulting in foul smelling steatorrhea with bulky stools, weight loss and occasionally deficiency of fat soluble vitamins Vitamins A, D, E and Vitamin K. Vitamin A deficiency leads to night blindness, dry eyes  and keratoconjunctivitis and is likely the reason for his difficulty driving.

Try again!. The patient has already lost over 20 pounds and placing him on a restrictive diet may result in further weight loss. A gluten free diet should not be recommended for this patient, unless a diagnosis of celiac disease is made.

Try again! Since the patient has no other signs of inflammatory bowel disease, colonoscopy would not be the next best step.