American Board of Internal Medicine (ABIM) Certification Practice Exam

What are the common clinical features associated with the diagnosis of chronic pancreatitis?

1. Pain and recurrent attacks of pancreatitis

2. Jaundice and fever

3. Constipation and abdominal swelling

4. Hyperglycemia and hypertension

The correct answer is: Pain and recurrent attacks of pancreatitis

The diagnosis of chronic pancreatitis is commonly characterized by persistent abdominal pain and recurrent episodes of pancreatitis. Patients often experience episodes of acute pancreatitis that can lead to chronic inflammation, contributing to a spectrum of clinical symptoms over time. The pain associated with chronic pancreatitis is typically located in the upper abdomen and can radiate to the back, often described as a constant, gnawing discomfort that can be exacerbated by eating or drinking alcohol. This chronic pain may vary in intensity and can be intermittent, aligning with the episodes of acute exacerbations. Recurrent attacks of pancreatitis are significant in the context of chronic pancreatitis because they signify ongoing damage to the pancreatic tissue, which can lead to further complications such as pancreatic insufficiency, diabetes, and the risk of developing pancreatic cancer. Proper identification of pain and the history of recurrent episodes is crucial in confirming the diagnosis and guiding appropriate management strategies. Other choices may present associated symptoms of different conditions or complications, but they do not capture the hallmark features necessary for diagnosing chronic pancreatitis.