Pancreatic Islet Cell Tumors

Question 1

What is needed to diagnose an Insulinoma?

Answer 1

Hypoglycemia + elevated insulin

Question 2

What is the best initial test for an Insulinoma?

Answer 2

Low glucose + high C-peptide

Question 3

What is the most specific test for an Insulinoma?

Answer 3

72 hour fasting with High C-peptide + absence of ketosis

Question 4

How do you treat an Insulinoma?

Answer 4

Laparoscopic Surgical Removal

Question 5

How is a Glucagonoma Diagnoses?

Answer 5

Hyperglycemia + Weight loss that is 100% pancreatic origin

Question 6

What are Glucagonomas associated with?

Answer 6

Necrolytic Migratory Erythema

Question 7

How do you treat Glucagonomas?

Answer 7

Octreotide (somatostatin) and Surgical resection

Question 8

How does a VIPoma present?

Answer 8

Secretory, high-volume watery diarrhea, Hypokalemia and Achlorrydria

Flushing, lethargy, nausea and vomiting

Question 9

How do you confirm a VIPoma?

Answer 9

high levels of Vasoactive Intestinal peptide (VIP)

Question 10

What are diagnostic testing options for a VIPoma?

Answer 10

Low osmotic gap for diarrhea, low Fe, Low B12

Question 11

How do you treat a VIPoma?

Answer 11

Surgical resection