All of the following are features of Zollinger Ellison syndrome except -
Ans. is 'c' i.e., Beta cell tumours of pancrease Gastrinoma or Zollinger Ellison syndrome is a non b cell neuroendocrine tumour of the pancreasIt secretes gastrinPathophysiology of GastrinomaGastrinoma - Increase secretion of gastrin - marked gastric acid hypersecretion - peptic ulcerPancreatic Neuroendocrine Tumors Gastrinoma (non b cell tumour)GastrinDuodenum (70%) Pancreas (25%) other sites (5%)60-90Pain (79-100%)Diarrhoea (30-73%)GERD (30-35%)Peptic ulcerInsulinoma (b cell tumour)InsulinPancreas > 99% (Insulinomas are distributed equally on head body and tail of pancrease)< 10Symptoms of hypoglycemiaSymptoms relieve on administration of glucoseVIPOMA (Vomer-Morrison syndrome,pancreatic cholera,WDHA)Vasoactive intestinalpeptidePancreas 90%40-70Watery diarrhoea (90-100%)Hypokalemia (80-100%)HypochlorhydriaDehydration (83%)Flushing (20%)GlucagonomaGlucagonPancreas 100% (usually occurs singly in pancreatic tail)50-80%Dermatitis (migratory necrolytic erythema) 67-90%Glucose intolerance (40-90%)Weight loss (66 to 96%)Anemia (33-85%)Diarrhoea (15-29%)Thromboembolism
Intractable peptic ulcers
Severe diarrhoea
Beta cell tumours of the pancreas
Very high acid output
Pathophysiology - Neoplasms