GI: Cases Flashcards
A patient presents with the following, which is concerning for…
- indegestion, abd. pain, oily diarrhea
- relief via eating and antacids
zollinger-ellison syndrome
What imaging modality is used to assess potential ulceration in zollinger-ellison syndrome?
endoscopy
What four lab tests can be administered to evaluate for zollinger ellison syndrome?
Serum gastrin, Basal Gastric H+, Pentagasatrin stimulation test, secretin stimulation test
What results would you expect in zollinger-ellision when taking a serum gastrin and basal gastric H+ secretion?
highly elevated
What is the expected result of pentagastrin stimulation test in zollinger-ellison?
no increase
what is the expected result of secretin stimulation test in zollinger-ellison?
increase to 1000 pg/ml
With zollinger-ellison, what may be seen on CT?
gastrinoma
Laproscopic surgery is definitive tx for zollinger-ellison. What drug should be given while awaiting surgery?
omeprazole (PPIs)
What is the cause of excess gastrin release in Zollinger-ellison? Is it regulated by feedback mechanisms?
gastrinoma
no feedback regulation
Where are gastrinomas commonly located?
duodenum or pancreas
What doesn’t pentagastrin stimulation (a gastrin analogue) have any effect in zollinger-ellison?
H+ secretion already maximal
In the secretin stimulation test, secretin stimulates which cells to release gastrin?
gastrinoma cells, not G cells
What causes steatorrhea in zollinger-ellison?
pancreatic lipase inhibition due to low pH
a complete ileal resection would result in a loss of _____ meters.
2 to 4 meters
An ileal loss of more than _____ cm will distrupt enterohepatic circulation of what substance?
100 cm
bile salt recovery