Rosh Internal Medicine Boost Practice Exam

For a woman with chronic pancreatitis, which test is indicated during routine care when her symptoms are controlled?

1. Abdominal ultrasound

2. Fasting glucose level

3. Magnetic resonance cholangiopancreatography

4. Serum amylase and lipase

The correct answer is: Fasting glucose level

In the context of managing a woman with chronic pancreatitis, monitoring her fasting glucose level is particularly important, especially when her symptoms are controlled. Chronic pancreatitis can lead to endocrine dysfunction, primarily affecting the pancreatic beta cells responsible for insulin production. Over time, damage to the pancreas can result in impaired glucose metabolism and eventually lead to diabetes mellitus. By checking the fasting glucose level, healthcare providers can assess the pancreatic function related to insulin secretion and identify any early signs of diabetes. This is a crucial part of routine care because managing blood glucose levels is essential for the woman's overall health and to prevent complications associated with diabetes. While abdominal ultrasound can be useful for initial evaluation and assessing complications, it is not specific for monitoring the metabolic aspects of chronic pancreatitis. MRI and MRCP can be useful for detailed imaging of the pancreatic duct but are not typically required for routine care when the patient's symptoms are stable. Serum amylase and lipase are useful for diagnosing acute exacerbations of pancreatitis but are not relevant in the context of routine monitoring when symptoms are controlled, as these enzymes remain elevated in chronic conditions regardless of symptom control.