NBME 16 Gastrin (NBME Answers)

+6
submitted by zincy7(14),

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ugrBnni Alidmnbao iPan suhor eratf atgnei = asiGrct euclr
akcBl ostlso rfo 2 dsya = ???
ryfaeorRct to CTO nscadAit dan H2 Brscelko
gaitnewS adn woL PB
aicneaPtrc aMss = osmt lkilye INTORAASMG

GOCLI

lcnsmcteiaomhuImioh elanlgib euss saidoentbi sa krraems orf ahwt yteh natw to d.ifn nI shit saec, e'wer tcipnssegu angtsri einvg hte tsmmpsyo

:etoN ouY dhlsou vieesr het ,tniuocfn tiaomin,utls dna iets fo eaersel ofr hcae of the oosenmrh modenetin sa elwl

NEF :EERRECegnZlllosi-ioErnl Sryonemd

bingcentipede Black stool because blood in the GI tract? +1

passplease I was tempted to pick insulin, because of the orthostatics and sweating that could resemble hypoglycemic episodes. Why are those present in a gastrinoma? +3

deberawr @passplease it's possible that increased gastrin -> peptic ulcers -> perforation -> shock -> sympathetic nervous system overload -> sweating and hypotension +

jsanmiguel415 Black stool = melena = bleeding above the ligament of trietz from ulcers +

rina @passplease according to amboss gastrinomas can cause steatorrhea and malabsorption, in addition to anemia from GI bleeding. that might explain the light headedness and low-ish bp. +

jj375 Zollinger Ellison Syndrome --> causes duodenal ulcers that are bleeding causing melena and the low blood volume (symptoms of light headed and low BP). I would guess that sweating is from what @deberawr said of the increased sympathetics from the low blood volume +

cheesetouch FA18 347 zollinger ellison +