All of the following are features of Zollinger Ellison syndrome except -: (A) Intractable peptic ulcers, (B) Severe diarrhoea, (C) Beta cell tumours of the pancreas, (D) Very high acid output
Answer is C. 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