Gastroenterology: Zollinger-Ellison syndrome: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Gastroenterology: Zollinger-Ellison syndrome

Sample item

A patient has multiple recurrent ulcers in the duodenum and jejunum, diarrhoea and fasting serum gastrin of 1500 pg/mL with gastric pH of 1. Where is the tumour most commonly found?

AThyroidBAppendixCAdrenal medullaDGastrinoma triangle involving duodenum and pancreas

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Gastrinoma triangle involving duodenum and pancreas

Zollinger-Ellison syndrome results from a gastrin-secreting tumour, most often in the duodenum or pancreatic head within the gastrinoma triangle. High gastrin with acidic gastric pH confirms it. High-dose PPIs control acid and tumour resection is attempted, with MEN1 considered.

Option by option

A. Thyroid
Thyroid disease does not cause this syndrome.
B. Appendix
The appendix hosts carcinoids, not gastrinoma.
C. Adrenal medulla
Adrenal tumours cause catecholamine excess.
D. Gastrinoma triangle involving duodenum and pancreas (correct)
Correct. The duodenum and pancreas are the typical sites.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is D, Gastrinoma triangle involving duodenum and pancreas. Zollinger-Ellison syndrome results from a gastrin-secreting tumour, most often in the duodenum or pancreatic head within the gastrinoma triangle.

Why is "Thyroid" not the answer?

Thyroid disease does not cause this syndrome.

Why is "Appendix" not the answer?

The appendix hosts carcinoids, not gastrinoma.

Why is "Adrenal medulla" not the answer?

Adrenal tumours cause catecholamine excess.

What concept does this question test?

It tests Gastroenterology: Zollinger-Ellison syndrome in General Medicine. High gastrin with acidic gastric pH confirms it. High-dose PPIs control acid and tumour resection is attempted, with MEN1 considered.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Gastroenterology: Zollinger-Ellison syndrome?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.