American Board of Internal Medicine (ABIM) Certification Practice Exam

What type of diarrhea can be directly linked to malabsorption syndromes?

1. Steatorrhea

2. Ischemic

3. Secretory

4. Invasive

The correct answer is: Steatorrhea

Steatorrhea is characterized by the presence of excess fat in the stool, which is a direct consequence of malabsorption syndromes. In conditions such as celiac disease, pancreatitis, or other disorders affecting the intestines, the body's ability to absorb fats and other nutrients is compromised. As a result, undigested fat is excreted in the stool, leading to foul-smelling, bulky stools that float. This type of diarrhea specifically indicates a problem with the absorption of dietary lipids and is quintessential in diagnosing malabsorption syndromes. Other forms of diarrhea, such as ischemic, secretory, and invasive, have different underlying mechanisms and do not typically correlate directly with malabsorption. Ischemic diarrhea relates to inadequate blood flow to the intestines; secretory diarrhea occurs when the intestines secrete more electrolytes and water than they absorb, often due to infection or toxins; and invasive diarrhea is associated with pathogens that disrupt intestinal lining, leading to inflammation and ulceration rather than malabsorption.