This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Surgery
Zollinger-Ellison syndrome is characterized by all of the following except - 
Select and explain. 
A. Post bulbar ulcer, B. Recurrent duodenal ulcer, C. Severe diarrhea, D. Massive HCL in response to histamine injection
D: Massive HCL in response to histamine injection
Answer: D: Massive HCL in response to histamine injection 
Explanation: Important points that should raise the possibility of ZES in patients with duodenal ulcer.


ulcers in unusual locations i.e. postbulbar ulcers
recurrent or refractory ulcers
ulcers with diarrhoea
multiple ulcers
ulcers associated with prominent gastric folds
ulcers with findings s/o MEN-1 (endocrinopathy, family history of ulcer or endocrinopathy, nephrolithiasis)
ulcers without H. pylori infection