Ulcerogenic cause of hypergastrinemia

Free MCQ with CSS Toggle
Q) A 42-year-old male presents with multiple recurrent duodenal ulcers, abdominal pain, and chronic diarrhea. Fasting serum gastrin levels are >1000 pg/mL. Which of the following is the most likely ulcerogenic cause of hypergastrinemia?
Answer: B. Zollinger–Ellison syndrome

🔍 Explanation:
Zollinger–Ellison syndrome (ZES) is caused by a gastrinoma (a gastrin-secreting tumor), typically located in the pancreas or duodenum.

It leads to massive hypergastrinemia, increased gastric acid secretion, and multiple, recurrent, or atypical peptic ulcers.

Diarrhea and steatorrhea are common due to acid inactivation of pancreatic enzymes.

Other Options:
A. Atrophic gastritis:
Leads to hypochlorhydria/achlorhydria with secondary hypergastrinemia, but non-ulcerogenic (low acid state).

C. Chronic PPI use:
Causes compensatory hypergastrinemia due to acid suppression, but again non-ulcerogenic unless stopped abruptly in predisposed individuals.

D. Helicobacter pylori infection:
May increase gastrin levels mildly, but ulcers are primarily due to mucosal damage and inflammation, not from gastrin hypersecretion.

🧠 Key Point: Zollinger–Ellison syndrome is the only ulcerogenic cause of hypergastrinemia. Fasting gastrin >1000 pg/mL with low gastric pH is diagnostic.

📘 Recommended for Surgeons: Get Surgery Essentials
Like2

H. Pylori Serology

Q: Which of the following is the primary reason why serology is not recommended for evaluating H. pylori treatment success?

# Stomach — INI GI Mock Test

A) Serological tests are less sensitive than stool antigen and urea breath tests.
B) Antibody levels can remain elevated for months to years after infection is eradicated.
C) Serological tests lack the ability to detect IgG antibodies accurately.
D) Serology tests have a specificity of less than 50%.
🔒 This is a premium MCQ. Only logged-in premium members can view the answer.

Dumping Syndrome

Q) What is the mechanism of action of Octreotide in dumping syndrome ?

a) Acceleration of gastric emptying

b) Shortening of small bowel transit time

c) Inhibition of endocrine secretions

d) All the above

Answer: C

  • Octreotide alleviates both early and late dumping symptoms through inhibition of hormone mediators.
  • It also delays gastric emptying time and inhibits splanchnic vasodilation.

Shack, 8th, 722.

  • These peptides not only inhibit gastric emptying but also affect small bowel motility so that intestinal transit of the ingested meal is prolonged.

Sabistan, 21st, 1217.

Snippets

  • Late dumping occurs 1 to 3 hours after a meal and is less common.
  • The basic defect of late dumping is also rapid gastric emptying; however, it is related specifically to carbohydrates being delivered rapidly into the proximal intestine.