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19 Cards in this Set
- Front
- Back
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zollinger ellison syndrome
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gastrin oversecretion by gastrinoma
parietal cell is overactive -> PUD -> diarrhea, steatorrea treatment is suppression with PPI |
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carcinoid tumors
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secrets serotonin
have somatostatin receptors - use for diagnosis/treatment carcinoid syndrome - flushing and diarrhea due to serotonin mets to liver |
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carcinoid syndrome
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flushing and diarrhea associated with carcinoid tumors due to release of serotonin and histamine
also see hepatomegaly |
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Multiple endocrine neoplasia 1 (MEN-1) - Wermer's Syndrome
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hyperparthyroidism
pancreatic islet cell tumors pituitary tumors (often prolactinoma) - acromegaly |
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Multiple endocrine neoplasia 2 (MEN-2)
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thyroid, pheocromocytoma
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three most common causes of PUD
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H. Pylori
NSAIDS Gastrinoma |
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gastrinoma triangle
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proximal part of duodenum bounded by the head of pancreas, gallbladder
NETs arise from endocrine elements of intestinal wall, pancreas, peripancreatic tissue |
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detection of gastinomas
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octreotide scan - binds samatostatin receptors
endoscopic ultrasound CT |
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gastrinoma treatment
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acid supression: PPI
total gastrectomy somatostatin analog |
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T/F carcinoid tumors have the highest rate of metastasis in the small bowel compared to other GI-NETs
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true
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cardinal manifestation of NETs
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all NETs cause diarrhea
gastrionoma - low pH deactivates pancreatic enzymes Carcinoid - serotonin, histamine induced VIPoma MEN-2 glucagonoma |
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most common NET
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gastrinoma (zollinger ellison syndrome)
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gastric polyp differential
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cystic glanular polyp
adenoma carcinoid GIST |
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foregut carcinoid vs midgut carcinoid vs hindgut carcinoid
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foregut - proximal to ligament, rare metastisis, very curable, associated with gastric atrophy
midgut carcinoids - jejunum and ileum, aggressive, obstruction hindgut - appendix and colorectal - benign |
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gastric carcinoids types
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1 - associated with atrophic gastritis (PPI overuse) and pernicious anemia, high gastrin, small multiple tumors - 80% of gastric carcinoids
2 - zolinger ellison syndrome and MEN-1, high gastrin, small, multiple tumors 3 - sporadic, not assocated with gastric atrophy or high gastrin, large single tumor - only one associated with carcinoid syndrome |
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Gastrinoma (PET)
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peptic ulcer disease
gastric hypersecretion gastrin producing tumor high acid secretion overwhelms bicarb secretion, decreased pH, denature pancreatic enzymes, failed micelle formation |
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VIPoma (PET)
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watery diarrhea, hypokalemia, achlorhydria
VIP activates adenylate cyclase -> make cAMP to induce intestinal water/chloride secretion, decreases acid |
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Somatostatinoma (PET)
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diabetes
gallbladder disease steatorrhea inhibition of pancreatic enzymes, bicarb, gallbladder contraction, lipid absorption, and acid secretion |
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Glucagonoma (PET)
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dermatitis
glucose iintolerance weightloss anemia necrolytic migratory erythema |
