A 50-Year-Old Man with a Remote History of Alcohol Dependence

question 11

Multiple Choice

A 50-year-old man with a remote history of alcohol dependence is evaluated in the clinic for chronic diarrhea and weight loss.  The patient has had bloating with daily loose stools for the past 2 years.  His stool is described as greasy and malodorous.  Pancreatic insufficiency is suspected despite normal abdominal imaging.  The patient undergoes a test in which bicarbonate concentration is measured from duodenal aspirates as hormone A is infused intravenously.  The data is plotted in the graph below. Hormone A is most likely produced by which of the following cell types?

• A)Duodenal S cells
• B)Gastric G cells
• C)Pancreatic alpha cells
• D)Pancreatic beta cells
• E)Parenchymal hepatocytes
• F)Renal peritubular cells

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