Which of the following is a rare disease in which tumours cause the stomach to produce too much acid, resulti… - DSSSB 14 August 2024

DSSSB 14 August 2024

Medical & Surgical Nursing

Easy

Appeared in: DSSSB 14 August 2024

Explanation

Zollinger-Ellison syndrome (ZES) is a rare disorder caused by gastrin-secreting tumors, known as gastrinomas.
These tumors, typically located in the pancreas or duodenum, release excessive amounts of the hormone gastrin.
Gastrin stimulates the parietal cells in the stomach to produce massive quantities of acid (gastric acid hypersecretion).
This extreme hyperacidity overwhelms the mucosal defenses, leading to the formation of severe, recurrent, and often multiple peptic ulcers.
Patients may also experience chronic diarrhea, as the high acid load can inactivate pancreatic digestive enzymes.

Option A: Boerhaave syndrome is a full-thickness rupture of the esophagus, a mechanical injury usually caused by severe vomiting. It is not caused by tumors or chronic acid overproduction.
Option C: Mallory-Weiss syndrome is a partial-thickness tear (laceration) in the mucosa at the gastroesophageal junction, also typically caused by forceful retching or vomiting. It causes hematemesis but is not related to acid-producing tumors.
Option D: Abdominal compartment syndrome is a condition of dangerously elevated pressure within the abdominal cavity, leading to organ failure. It is typically a complication of major trauma, surgery, or severe sepsis, not a primary disease of acid secretion.

Clinical Relevance

Nursing practice connection: Knowing Pathophysiology of Zollinger-Ellison Syndrome helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses should suspect ZES in patients who present with multiple, recurrent, or treatment-resistant peptic ulcers, especially if located in unusual sites like the distal duodenum or jejunum.
The cornerstone of nursing management is the administration of high-dose proton pump inhibitors (PPIs) to control acid secretion and vigilant monitoring for complications such as gastrointestinal bleeding, perforation, and electrolyte imbalances from chronic diarrhea.
What if? If a patient with ZES also has signs of hypercalcemia (from hyperparathyroidism) or a pituitary tumor, the nurse should recognize the possibility of Multiple Endocrine Neoplasia type 1 (MEN1), a genetic syndrome of which ZES is a common component.

How to Approach the Question

First, carefully read the question and identify the key defining features of the condition described. The keywords are 'rare disease', 'tumours', 'stomach produces too much acid', and 'peptic ulcers'.
Next, systematically evaluate each option based on these keywords.
Recall the definitions of each syndrome. Boerhaave and Mallory-Weiss syndromes are associated with physical tearing or rupture of the esophagus/stomach junction, usually from vomiting.
Eliminate Abdominal Compartment Syndrome, as it relates to intra-abdominal pressure, not acid production.
Recognize that Zollinger-Ellison syndrome perfectly matches the description: it involves tumors (gastrinomas) that secrete a hormone (gastrin) causing the stomach to produce excess acid, leading to ulcers.
Confirming this direct match identifies it as the correct answer.

Concept Tested & Keywords

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E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed p. 774-776

E6 Nursing Brunner Adult Health 3SA Vol 1 Part 2 p. 141-143

E6 Medicine Davidson Principles Practice 24e p. 822-824