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		<swivt:creationDate rdf:datatype="http://www.w3.org/2001/XMLSchema#dateTime">2026-07-31T12:14:20+00:00</swivt:creationDate>
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		<rdf:type rdf:resource="https://www.wikidoc.org/index.php/Special:URIResolver/Category-3AWBRQuestion"/>
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		<rdfs:label>WBR0740</rdfs:label>
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		<swivt:page rdf:resource="https://www.wikidoc.org/index.php/WBR0740"/>
		<swivt:wikiNamespace rdf:datatype="http://www.w3.org/2001/XMLSchema#integer">0</swivt:wikiNamespace>
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		<property:AnswerA rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Secretion of more than one type of hormone</property:AnswerA>
		<property:AnswerAExp rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Polyhormone secretion in gastrinoma, such as co-secretion of gastrin and ACTH, is associated with poorer prognosis.</property:AnswerAExp>
		<property:AnswerB rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Liver metastasis</property:AnswerB>
		<property:AnswerBExp rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Liver metastasis is associated with increased mortality and poor prognosis.</property:AnswerBExp>
		<property:AnswerC rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Very high gastrin levels</property:AnswerC>
		<property:AnswerCExp rdf:datatype="http://www.w3.org/2001/XMLSchema#string">A very high level of gastrin, above 700 pg/mL, is associated with poorer prognosis.</property:AnswerCExp>
		<property:AnswerD rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Overexpression of growth factors</property:AnswerD>
		<property:AnswerDExp rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Overexpression of growth factors is associated with low curability and aggressive disease.</property:AnswerDExp>
		<property:AnswerE rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Duodenal location of primary tumor</property:AnswerE>
		<property:AnswerEExp rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Pancreatic location of primary tumor is shown to be associated with worse outcome and poorer prognosis compared to its its duodenal counterpart.</property:AnswerEExp>
		<property:Approved rdf:resource="&wiki;Yes"/>
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		<property:Explanation rdf:datatype="http://www.w3.org/2001/XMLSchema#string">The patient is presenting with signs and symptoms consistent with gastrinoma or Zollinger-Ellison syndrome. The prognosis of gastrinoma is affected by several factors. Prognosis is poorer among patients with gastrin levels beyond 700 pg/mL, metastasis to the liver, co-secretion of other hormones such as ACTH, and overexpression of growth factors. The size of the tumor is more likely  to be a prognostic factor than the actual location, as to whether it originates from the pancreas or the duodenum. Nonetheless, pancreatic gastrinoma is associated with poorer prognosis compared to its its duodenal counterpart.&lt;br/&gt;
'''Educational Objective:''' Pancreatic gastrinoma is associated with worse outcome compared to its its duodenal counterpart.&lt;br/&gt;
'''References:''' Ellison EC, Johnson JA. The Zollinger-Ellison syndrome: a comprehensive review of historical, scientific, and clinical considerations. Curr Probl Surg. 2009;46(1):13-106.&lt;br&gt;
First Aid 2014 page 329</property:Explanation>
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		<property:Prompt rdf:datatype="http://www.w3.org/2001/XMLSchema#string">A 45-year-old man with no past medical history presents to the physician's office with complaints of persistent diarrhea and abdominal pain for the past 3 weeks. The patient also reports recent unintentional weight loss. He denies the use of any medication and has no allergies. On endoscopy, the patient is found to have multiple ulcers in the duodenum and the jejunum. Acid output is measured and is abnormally elevated.  Which of the following does not correlate with the severity of the disease in this patient?</property:Prompt>
		<property:RightAnswer rdf:datatype="http://www.w3.org/2001/XMLSchema#string">E</property:RightAnswer>
		<property:SubCategory rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Gastrointestinal</property:SubCategory>
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		<property:WBRKeyword rdf:resource="&wiki;Diarrhea"/>
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		<property:WBRKeyword rdf:resource="&wiki;Ellison"/>
		<swivt:wikiPageModificationDate rdf:datatype="http://www.w3.org/2001/XMLSchema#dateTime">2020-10-28T01:32:20Z</swivt:wikiPageModificationDate>
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