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Cystic fibrosis pancreatic obstruction — MRCPCH TAS MCQ

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HardPathologyCystic fibrosis pancreatic obstructionMRCPCH TAS

An infant with recurrent chest infections has bulky greasy stools and poor weight gain. Sweat chloride is raised. What pathological process most directly causes the malabsorption?

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Correct answer: E — Obstruction of pancreatic ducts by thick secretions

Cystic fibrosis causes thick secretions that obstruct pancreatic ducts, leading to exocrine pancreatic insufficiency and fat malabsorption. Villous atrophy from gluten exposure causes coeliac disease and would not explain raised sweat chloride. The pearl is that pancreatic insufficiency is common in severe CFTR dysfunction.

Reference: Nelson Textbook of Pediatrics; NICE NG78 cystic fibrosis; RCPCH Theory examination syllabi