Steatorrhea and megaloblastic anemia, occurring in a patient after bowel resection, is caused by a failure to absorb what? SELECT ONE.
**Core Concept**
The underlying principle being tested here is the importance of bile salts in fat absorption and the role of vitamin B12 in maintaining healthy red blood cells. Steatorrhea, or excessive fat in the stool, and megaloblastic anemia, a condition characterized by large, abnormal red blood cells, suggest an issue with fat and vitamin B12 absorption.
**Why the Correct Answer is Right**
After a bowel resection, the patient may experience a reduction in the absorptive surface area of the small intestine. The ileum, the final section of the small intestine, is particularly important for the absorption of bile salts and vitamin B12. Bile salts are essential for the emulsification of fats, making them accessible to pancreatic enzymes. Vitamin B12, on the other hand, is bound to intrinsic factor in the ileum and absorbed through a receptor-mediated process. A failure to absorb bile salts and vitamin B12 can lead to steatorrhea and megaloblastic anemia, respectively.
**Why Each Wrong Option is Incorrect**
**Option A:** Incorrect because while fiber is an important component of a healthy diet, its malabsorption is not directly linked to steatorrhea and megaloblastic anemia.
**Option B:** Incorrect because although protein is essential for overall health, its malabsorption is not specifically associated with steatorrhea and megaloblastic anemia.
**Option C:** Incorrect because while carbohydrates are vital for energy production, their malabsorption is not directly related to steatorrhea and megaloblastic anemia.
**Clinical Pearl / High-Yield Fact**
The ileum is responsible for the absorption of approximately 90% of vitamin B12 and 100% of bile salts. Any resection or disease affecting this region can lead to malabsorption of these essential nutrients.
**Correct Answer:** D. Vitamin B12