Pancreatic Islet Cell Tumors

Question 1

who are the Pancreatic Islet Cell Tumors

Answer 1

insulinoma, glucagonoma, VIPoma, and gastrinoma

Question 2

Insulinoma labs?

Answer 2

Hypoglycemia + High insulin level = Insulinoma

Question 3

Insulinoma malign?

Answer 3

Most are benign (not malignant)

Question 4

Insulinoma Best initial test

Answer 4

Low glucose + High C-peptide

Question 5

Insulinoma Most specific test

Answer 5

72 hour fasting with high C-peptide + Absence of ketosis

maybe then, u can get a CT of abdomen (pancreas)

Question 6

Insulinoma tx

Answer 6

laparoscopic surgical removal

Question 7

Glucagonoma lab and cxfx

Answer 7

Hyperglycemia and weight loss with 100% pancreatic origin

Question 8

Glucagonoma Skin lesion

Answer 8

Necrolytic migratory erythema

“a ver, esta glucosa tan alta parece una diabetes con la piel escoñetada o o un Necrobiosis lipoidica, PERO WAIT no, este hombre no tiebe diabetes, tiene un GLUCAGONOMA con su síndrome paraneoplásico NME”

Question 9

Glucagonoma malign?

Answer 9

80%

Question 10

Glucagonoma tx

Answer 10

octreotide (somatostatin) and surgical resection

Question 11

VIPoma cxfx

Answer 11

secretory, high-volume, watery diarrhea; hypokalemia;

achlorhydria (no hydrochloric acid in the gastric secretions.) Measured via nasogastric tube

Question 12

VIPoma. How is osmotic gap, iron and b12

Answer 12

all low

Question 13

VIPoma Dx

Answer 13

High vasoactive intestinal peptide (VIP) levels + imaging

(CT/MRI/endoscopic ultrasound) showing a lesion in the pancreas

Question 14

VIPomas. medical treatment

Answer 14

Octreotide or lanreotide

Question 15

VIPoma tx

Answer 15

surgical resection