A man with a Hx of EtOH dependence and chronic abd pain as well as X-ray findings of "calcifications in the mid-upper abdomen" is most likely referring to a chronic pancreatitis.

This leads to a lack of lipase secretion hence, pale, foul-smelling stools with oil droplets per pt Hx. This pt's pancreas also doesn't secrete other enzymes, such as amylases, proteases, nor trypsinogen (to activate other enzymes), so the answer is "generalized malabsorption".

(D) Portal hypertension: Portal hypertension is a complication of longstanding alcoholism, but it is not the cause of acute or chronic pancreatitis.

In acute pancreatitis, alcohol transiently increases pancreatic exocrine secretion and contraction of the sphincter of Oddi (the muscle regulating the flow of pancreatic juice through papilla of Vater).

This leads to activation of pancreatic enzymes and acute pancreatitis follows soon after.

In chronic pancreatitis (as in this patient), alcohol increases the protein concentration of pancreatic secretions, and this protein-rich pancreatic fluid can form ductal plugs.

Made this explanation in case any of you were dumb enough to think "pancreatitis → alcohol → portal hypertension" like me.

F**K this question!

Know exactly what the disease is without knowing what the f**king "generalized malabsorption" means!!