Zollinger-Ellison syndrome is characterized by all of the followingexcept
Answer is D (Massive HCL in response to histamine injection) : Massive secretion of HCI is seen in response to stimulation with Secretin (not with Histamine). Zollinger Ellison Syndrome (as mentioned in the previous question) is characterized by unregulated secretion of gastrin leading to hypersecretion of gastric acid and the resulting manifestations. The most common presentation is with : Peptic ulceration Q : * Most common manifestation, occuring in 90% of patient * Most common site is duodenum (duodenal bulb) * Clinical situations that raise special suspicion include : a. Ulcers beyond the duodenal bulb (second pa of duodenum and beyond) because these are unusual locations for ulcers in Peptic ulcer diseases.Q b. Ulcers refractory to standard medical therapy Q c. Ulcers are recurrentQ d. Ulcers presenting with frank complications.Q Diarrhea Q : Is the most common manifestation Q Etiology is multi factorial, and it may have a secretory component as well. Gastrin provocative tests are used when acid secretory studies are not contributory and include : 1. Secretin stimulation test Q most sensitive and specific Q 2. Calcium infusion test 3. Standard meal test Histamine stimulation is not used and it does not bring about massive release of HCI in such patients.
Post bulbar ulcer
Recurrent duodenal ulcer
Severe diarrhea
Massive HCL in response to histamine injection