Approach to vomiting (chronic) Quiz: Ace Your Exams

Get ready to dominate your medical and nursing exams by using our dynamic quizzes to elevate your knowledge and increase your confidence. Whether you're gearing up for the USMLE®, COMLEX®, or your next in-class assessment, Osmosis quizzes tackle key topics in pathology, diagnostics, and treatment approaches. By honing in on clinical readiness and decision-making, we make sure the knowledge you gain empowers you both in the classroom and in real-world practice. Jump in and supercharge your exam prep!

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A 62-year-old man presents to his primary care physician because he has been having intermittent vomiting and abdominal pain. This has occurred occasionally over the past three years but has been occurring more frequently for the past few months. Abdominal pain occurs after eating and is located in the upper abdomen with radiation to the back. The patient’s stools seem to be “greasy” and are difficult to flush. He has no melena or hematochezia. He drinks three glasses of whiskey every evening and six beers per day. He smokes one pack of cigarettes per day. Temperature is 37.0°C (98.6°F), pulse is 90/min, respiratory rate is 16/min, and blood pressure is 142/92 mmHg. On physical examination, there is mild epigastric tenderness to palpation. Laboratory studies show serum C-reactive protein of 0.2 mg/dL, serum lipase of 138 U/L, and fecal elastase of 152 µg/g (normal = >200 µg/g). Which of the following is the best next step in management? 

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