Feeling hormonal

Question 1

S/S of Insulinoma

Answer 1

Episodic hypoglycemia w/ mental status changes

Decreased serum glucose, elevated insulin, elevated C peptide

Question 2

S/S of Gastrinoma

Answer 2

Treatment resistant peptic ulcers (think Zollinger-Ellison Syndrome!!)

Diarrhea, abdominal pain; multiple ulcers, may extend into jejunum

Associated w/ MEN-I

Question 3

S/S of Somatostatinoma

Answer 3

Achlorhydria (due to decreased gastrin)

Cholelithiasis w/ steatorrhea (decreased CCK)

Question 4

S/S of VIPoma

Answer 4

Watery diarrhea, hypokalemia, achlorhydria

Question 5

Glucagonoma

Answer 5

Necrolytic migratory erythema, diabetes mellitus, GI symptoms

Question 6

Carcinoid syndrome

Answer 6

Metastatic small bowel tumor secretes high levels of serotonin

Recurrent diarrhea, cutaneous flushing, asthmatic wheezing, R sided valvular disease

Elevated 5-HIAA in urine (due to metabolism of serotonin by MAO in liver)