A 3-Month-Old Boy Is Evaluated for Large-Volume Diarrhea and Failure

A 3-month-old boy is evaluated for large-volume diarrhea and failure to thrive.  The patient was born via spontaneous vaginal delivery at 38 weeks gestation.  His mother reports that the pregnancy was uncomplicated and there is no family history of gastrointestinal disease.  Physical examination shows mild abdominal distension, muscle wasting, and pitting edema.  Histochemical evaluation reveals absence of enteropeptidase activity in the proximal intestinal villi.  Activity of which of the following substances is most likely impaired in this patient?

A) Amylase
B) Bile salts
C) Lactase
D) Pepsin
E) Secretin
F) Trypsin

Correct Answer:

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