A ca infusion test b secretin injection test c acth

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A) CA INFUSION TEST B) SECRETIN INJECTION TEST C) ACTH STIMULATION TEST D) STEROID ASSAY B 261
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DIAGNOSIS OF ZOLLINGER ELLISON SYNDROME FIRST STEP (OBTAINS FASTING GASTRIN LEVEL): FIRST STEP IN THE EVALUATION OF A PATIENT SUSPECTED OF HAVING ZES IS TO OBTAIN FASTING GASTRIN LEVEL. - GASTRIN LEVEL IN NORMAL PERSON  <150 PG/ML. - GASTRIN LEVEL IN Z.E.S.  > 150 TO 200PG/ML. 262
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SECOND STEP (ASSESS GASTRIC ACID SECRETION): - BASAL ACID OUTPUT IN NORMAL PERSONS  <4 MEQ/H - IN ZOLLINGER ELLISON SYNDROMES BAO  >15 MEQ/H - BAO/MAO RATIO > 0.6  HIGHLY SUGGESSTIVE OF ZES. - BUT RATIO OF < 0.6  DOES NOT EXCLUDE THE DIAGNOSIS. 263
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THIRD STEP (PROVOCATIVE TESTS):- IN MOST CASES OF ZOLLINGER ELLISON SYNDROME MEASUREMENT OF FASTING GASTRIN AND BASAL ACID OUTPUT IS ENOUGH TO ESTABLISH THE DIAGNOSIS. PROVOCATIVE TEST ARE RARELY NEEDED FOR THE DIAGNOSIS. PROVOCATIVE TESTS ARE USED ONLY IN CASES, WHEN ACID SECRETORY STUDIES ARE INDETERMINATE. SECRETIN STIMULATION TEST. 264
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TREATMENT OF CHOICE FOR ZOLLINGER ELLISON SYNDROME IS  PROTON PUMP INHIBITORS (OMEPRAZOLE OR LANSOPRAZOLE). PPI’S HAVE REDUCED THE NEED FOR GASTRECTOMY. 265
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DRUG OF CHOICE IN ZOLLINGER ELLISON SYNDROME IS - A) RANITIDINE (AIIMS MAY 95) B) OMEPRAZOLE C) ANTACIDS D) BETA-BLOCKER B 266
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Q-INSULINOMA INSULINOMA TRUE ARE - A) PRESENT IN PANCREAS B) MOSTLY BENIGN C) SURGICAL THERAPY INDICATED IF DIAGNOSED 267
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INSULINOMAS ARE A BETA CELL ENDOCRINAL TUMOUR OF THE PANCREAS. THE SYMPTOMS ARE PRODUCED DUE TO EXCESSIVE SECRETION OF INSULIN CAUSING HYPOGLYCEMIA . MOST OF THE INSULINOMAS ARE SOLITARY AND BENIGN. ONLY ABOUT 10-15 % OF INSULINOMAS ARE MALIGNANT. (KEEP IN MIND THAT ALL OTHER ENDOCRINE TUMOURS OF PANCREAS ARE USUALLY MALIGNANT). 268
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CLASSIC DIAGNOSTIC CRITERIA IS “WHIPPLE’S TRIAD” SIGNS AND SYMPTOMS OF HYPOGLYCEMIA DURING FASTING. BLOOD GLUCOSE BELOW 2.8 MMOL/L (50 MG/DL) DURING SYMPTOMATIC EPISODES. RELIEF OF SYMPTOMS BY INTRAVENOUS ADMINISTRATION OF GLUCOSE. 269
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Q-INSULINOMA INSULINOMA TRUE ARE - A) PRESENT IN PANCREAS B) MOSTLY BENIGN C) SURGICAL THERAPY INDICATED IF DIAGNOSED A,B,C 270
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Q-DIAGNOSIS GOLD STANDARD INVESTIGATION FOR DIAGNOSIS OF INSULINOMA - (AI 09) A) BLOOD GLUCOSE LEVEL LESS THAN 30 MG% B) 72 HRS FASTING C) C PEPTIDE LEVELS LESS THAN 32 RIM D) SERUM INSULIN LEVELS 271
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THE MOST USEFUL DIAGNOSTIC TEST AND THE ONLY ONE INDICATED IN ALMOST ALL PATIENTS IS DEMONSTRATION OF FASTING HYPOGLYCEMIA IN THE PRESENCE OF INAPPROPRIATELY HIGH LEVEL OF INSULIN. THE PATIENT IS FASTED FOR 72 HRS OR TILL THE SYMPTOMS OF HYPOGLYCEMIA DEVELOP. WHEN HYPOGLYCEMIA DEVELOPS, SERUM LEVEL OF INSULIN IS MEASURED. “A RATIO ON PLASMA INSULIN TO GLUCOSE > 0.3 IS DIAGNOSTIC. ” 272
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LOCALIZATION OF THE TUMOUR:- ONCE THE DIAGNOSTIC HAS BEEN MADE, LOCALIZATION OF THE TUMOUR IS MUST FOR SURGERY.
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  • Winter '16
  • jean grey
  • chronic hepatitis, chronic liver failure

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