A 54-Year-Old Man Comes to the Office After a Year

question 515

Multiple Choice

A 54-year-old man comes to the office after a year of progressive fatigue and frequent loose stools.  He describes voluminous, foul-smelling stools that float and are difficult to flush.  The patient has lost about 9 kg (20 lbs) in the past 6 months.  He was hospitalized on multiple occasions several years ago for epigastric pain radiating to the back, nausea, and vomiting.  Lately, the patient has had intermittent episodes of similar pain lasting for 15-30 minutes after meals.  He has had no hematemesis, hematochezia, or melena.  The patient stopped drinking alcohol several years ago and does not use tobacco or recreational drugs.  Temperature is 37 C (98.6 F) , blood pressure is 118/80 mm Hg, and pulse is 78/min.  BMI is 19.5 kg/m².  Abdominal examination shows epigastric tenderness on deep palpation.  Bowel sounds are normal.  Which of the following is most likely to improve this patient's symptoms?

• A)Antimicrobial therapy
• B)Cholecystectomy and stone removal
• C)Gluten-free diet
• D)Helicobacter pylori eradication
• E)Mesenteric angioplasty
• F)Pancreatic enzyme supplementation
• G)Restriction of dairy products

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Definitions:

Manufacturing Overhead

All indirect costs related to the manufacturing process, including but not limited to utilities, rent, and maintenance of equipment.

Expired Insurance

An insurance policy that has reached its end date and is no longer in effect.

Prepaid Insurance

An asset account that represents insurance paid in advance before the coverage period, reflecting future economic benefits.

Work in Process

Inventory that includes goods in manufacturing that are not yet completed; represents a stage between raw materials and finished goods.