Diagnosis of Zollinger-Ellison syndrome
Diagnostic Test list for Zollinger-Ellison syndrome:
The list of medical tests
mentioned in various sources as
used in the diagnosis of Zollinger-Ellison syndrome
includes:
Zollinger-Ellison syndrome Diagnosis: Book Excerpts
Tests and diagnosis discussion for Zollinger-Ellison syndrome:
Physicians diagnose Zollinger-Ellison syndrome through blood tests to
measure levels of gastrin. They may check for ulcers by taking x-rays of
the stomach and duodenum or by doing an endoscopy, which involves looking
at the lining of these organs through a lighted tube.
(Source: excerpt from Zollinger-Ellison Syndrome: NIDDK)
Diagnostic Tests for Zollinger-Ellison syndrome: Online Medical Books
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Review excerpts from medical books online, free, without registration,
for more information about diagnostis of Zollinger-Ellison syndrome.
Seizures, simple partial:
History and physical examination
(Handbook of Signs & Symptoms (Third Edition))
Make sure to record the patient’s seizure activity in detail; your data may be critical in locating the lesion in the brain. Does the patient turn his head and eyes? If so, to what side? Where does movement first start? Does it spread? Because a partial seizure may become generalized, you’ll need to watch closely for loss of consciousness, bilateral tonicity and clonicity, cyanosis, tongue biting, and urinary incontinence. (See “Seizures, generalized tonic-clonic,” page 554.)
After the seizure, ask the patient to describe exactly what he remembers, if anything, about the seizure. Check the patient’s LOC, and test for residual deficits (such as weakness in the involved extremity) and sensory disturbances.
Then obtain a history. Ask the patient what happened before the seizure. Can he describe an aura or did he recognize its onset? If so, how — by a smell, a visual disturbance, or a sound or visceral phenomenon such as an unusual sensation in his stomach? How does this seizure compare with others he has had?
Also, explore fully any history — recent or remote — of head trauma. Check for a history of stroke or recent infection, especially with a fever, headache, or stiff neck.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Colorectal cancer:
Diagnosis
(Professional Guide to Diseases (Eighth Edition))
Only a tumor biopsy can verify colorectal cancer, but other tests help detect it:
❑Digital rectal examination can detect almost 15% of colorectal cancers.
❑Fecal occult blood test can detect blood in stools. However, it's commonly negative in patients with colon cancer.
❑ Proctoscopy or sigmoidoscopy can detect up to 66% of colorectal cancers.
❑ Colonoscopy permits visual inspection (and photographs) of the colon up to the ileocecal valve, and gives access for poly-pectomies and biopsies of suspected lesions.
❑ Computed tomography scan helps to detect areas affected by metastasis.
❑ Barium X-ray, using a dual contrast with air, can locate lesions that are undetectable manually or visually. Barium examination should follow endoscopy or excretory urography because the barium sulfate interferes with these tests.
❑Carcinoembryonic antigen, though not specific or sensitive enough for early diagnosis, is helpful in monitoring patients before and after treatment to detect metastasis or recurrence.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Gallbladder and bile duct cancer:
Diagnosis
(Professional Guide to Diseases (Eighth Edition))
No test or procedure, by itself, can diagnose gallbladder cancer. However, the following laboratory tests support the diagnosis when they suggest hepatic dysfunction and extrahepatic biliary obstruction:
❑baseline studies — complete blood count, routine urinalysis, electrolyte studies, enzymes
❑ liver function tests — typically reveal elevated serum bilirubin, urine bile and bilirubin, and urobilinogen levels in more than 50% of patients as well as consistently elevated serum alkaline phosphatase levels
❑ occult blood in stools — linked to the associated anemia
❑ cholecystography — may show calculi or calcification
❑ cholangiography — may locate the site of common duct obstruction
❑ magnetic resonance imaging — detects tumors.
The following tests help compile data that confirm extrahepatic bile duct cancer:
❑ liver function studies — indicate biliary obstruction: elevated levels of bilirubin [5 to 30 mg/dl], alkaline phosphatase, and blood cholesterol as well as prolonged prothrombin time
❑ endoscopic retrograde cannulization of the pancreas — identifies the tumor site and allows access for obtaining a biopsy specimen.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Introduction: Malignant Neoplasms:
Diagnostic methods
(Professional Guide to Diseases (Eighth Edition))
A thorough medical history and physical examination should precede sophisticated diagnostic procedures. Useful tests for the early detection and staging of tumors include X-ray, endoscopy, isotope scan, computed tomography scan, and magnetic resonance imaging, but the single most important diagnostic tool is a biopsy for direct histologic study of tumor tissue. Biopsy tissue samples can be taken by curettage, fluid aspiration (pleural effusion), fine-needle aspiration biopsy (breast), dermal punch (skin or mouth), endoscopy (rectal polyps), and surgical excision (visceral tumors and nodes).
An important tumor marker, carcinoembryonic antigen (CEA), although not diagnostic by itself, can signal malignancies of the large bowel, stomach, pancreas, lungs, and breasts. CEA titers range from normal (less than 5 ng) to suspicious (5 to 10 ng) to suspect (over 10 ng). CEA serves many valuable purposes:
❑as a baseline during chemotherapy to evaluate the extent of tumor spread
❑to regulate drug dosage
❑to prognosticate after surgery or radiation
❑to detect tumor recurrence.
Although no more specific than CEA, alpha-fetoprotein — a fetal antigen uncommon in adults — can suggest testicular, ovarian, gastric, and hepatocellular cancers. Beta human chorionic gonadotropin may point to testicular cancer or choriocarcinoma. Other commonly used tumor markers include prostate-specific antigen to detect and monitor prostatic cancer, and CA-125, useful for monitoring ovarian, colorectal, and gastric cancers.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Malignant spinal neoplasms:
Diagnosis
(Professional Guide to Diseases (Eighth Edition))
❑Spinal and lumbosacral magnetic resonance imaging confirm spinal tumor.
❑ X-rays show distortions of the intervertebral foramina; changes in the vertebrae or collapsed areas in the vertebral body; and localized enlargement of the spinal canal, indicating an adjacent block.
❑ Myelography identifies the level of the lesion by outlining it if the tumor is causing partial obstruction; it shows anatomic relationship to the cord and the dura. If obstruction is complete, the injected dye can't flow past the tumor. (This study is dangerous if cord compression is nearly complete because withdrawal or escape of cerebrospinal fluid (CSF) will allow the tumor to exert greater pressure against the cord.)
❑ Radioisotope bone scan demonstrates metastatic invasion of the vertebrae by showing a characteristic increase in osteoblastic activity.
❑ Computed tomography scan shows cord compression and tumor location.
❑ Frozen section biopsy at surgery identifies the tissue type.
❑ Lumbar puncture may be normal, abnormal, or nonspecific. It may show clear yellow CSF as a result of increased protein levels if the flow is completely blocked. If the flow is partially blocked, protein levels rise, but the fluid is only slightly yellow in proportion to the CSF protein level. Cytology of the CSF may show malignant cells of metastatic carcinoma.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Multiple endocrine neoplasia:
Diagnosis
(Professional Guide to Diseases (Eighth Edition))
Investigating symptoms of pituitary tumor, hypoglycemia, hypercalcemia, or GI hemorrhage may lead to a diagnosis of MEN. Diagnostic tests must be used to carefully evaluate each affected endocrine gland. For example, radioimmunoassay showing increased levels of gastrin in patients with peptic ulceration and Zollinger-Ellison syndrome suggests the need for follow-up studies for MEN I because 50% of patients with Zollinger-Ellison syndrome have MEN. After confirmation of MEN, family members must also be assessed for this inherited syndrome.
Magnetic resonance imaging or computed tomography scan of the abdomen may show pancreatic tumor. Insulin test may show increased levels and fasting blood sugar may be low.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Seizures, simple partial:
History and physical examination
(Professional Guide to Signs & Symptoms (Fifth Edition))
Be sure to record the patient’s seizure activity in detail; your data may be critical in locating the lesion in the brain. Does the patient turn his head and eyes? If so, to what side? Where does movement first start? Does it spread? Because a partial seizure may become generalized, you’ll need to watch closely for loss of consciousness, bilateral tonicity and clonicity, cyanosis, tongue biting, and urinary incontinence. (See “Seizures, generalized tonic-clonic,” page 708.)
After the seizure, ask the patient to describe exactly what he remembers, if anything, about the seizure. Check the patient’s LOC, and test for residual deficits (such as weakness in the involved extremity) and sensory disturbances.
Then obtain a history. Ask the patient what happened before the seizure. Can he describe an aura or did he recognize its onset? If so, how—by a smell, a visual disturbance, or a sound or visceral phenomenon, such as an unusual sensation in his stomach? How does this seizure compare with others he has had?
Explore fully any history, recent or remote, of head trauma. Check for a history of stroke or recent infection, especially with fever, headache, or a stiff neck.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Multiple Somatic Complaints:
Differential Overview
(Field Guide to Bedside Diagnosis)
❑ Anxiety
❑ Depression
❑ Hypothyroidism
❑ Premenstrual syndrome
❑ Hypochondriasis
❑ Somatization disorder
❑ Chronic fatigue syndrome
❑ Fibromyalgia
❑ Panic disorder
❑ Malingering
❑ Conversion reaction
Diagnostic Approach
This presentation is marked by multiple vague complaints, symptoms out of proportion to the physical findings, symptoms outside the anticipated spectrum of the organic disease, and symptoms that do not follow anatomic distributions. The patient is often more concerned with the physician accepting authenticity of symptoms than relieving them. Vague, diffuse descriptions or overly detailed and elaborate symptoms are suggestive. The patient seems to be amplifying normal bodily sensations. Psychological factors may be revealed in the symbolic choice of words (e.g., “lump in the throat”).
“Stress” for most patients is an acceptable framework within which to obtain psychological information. Care must be taken during the interview not to suggest that the symptoms are “all in the head.”
A thorough and thoughtful history and physical examination are the basis for chosing specific diagnostic tests, and signal to the patient that the complaints are being taken seriously.
» READ BOOK EXCERPT ONLINE »
Source: Field Guide to Bedside Diagnosis, 2007
Colorectal cancer:
Diagnosis
(Handbook of Diseases)
Only a tumor biopsy can verify colorectal cancer, but the following tests help detect it:
❑ Digital examination can help detect almost 15% of colorectal cancers.
❑ Hemoccult test (guaiac) may show blood in the stool.
❑ Proctoscopy or sigmoidoscopy can help detect up to 66% of colorectal cancers.
❑ Colonoscopy permits visual inspection (and photographs) of the colon up to the ileocecal valve and gives access for polypectomies and biopsies of suspected lesions.
❑ Computed tomography scan helps detect areas affected by metastasis.
❑ Barium X-ray, using a dual contrast with air, can locate lesions that are undetectable manually or visually. Barium examination should follow endoscopy or excretory urography because the barium sulfate interferes with these tests.
❑ Carcinoembryonic antigen, although not specific or sensitive enough for an early diagnosis, is helpful in monitoring patients before and after treatment to detect metastasis or recurrence.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Gallbladder and bile duct cancers:
Diagnosis
(Handbook of Diseases)
No test or procedure is in itself diagnostic of gallbladder cancer. However, the following laboratory tests support this diagnosis when they suggest hepatic dysfunction and extrahepatic biliary obstruction:
❑ baseline studies (complete blood count, routine urinalysis, electrolyte studies, enzymes)
❑ liver function tests (typically reveal elevated serum bilirubin, urine bile and bilirubin, and urobilinogen levels in more than 50% of patients as well as consistently elevated serum alkaline phosphatase levels)
❑ occult blood in stools (linked to the associated anemia)
❑ cholecystography (may show stones or calcification)
❑ cholangiography (may locate the site of common duct obstruction)
❑ magnetic resonance imaging (detects tumors).
The following tests help compile data that confirm extrahepatic bile duct cancer:
❑ liver function tests (indicate biliary obstruction: elevated levels of bilirubin [5 to 30 mg/dl], alkaline phosphatase, and blood cholesterol as well as prolonged prothrombin time)
❑ endoscopic retrograde pancreatography (identifies the tumor site and allows access for obtaining a biopsy specimen).
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Seizures, simple partial:
History
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Record the patient’s seizure activity in detail; your data may be critical in locating the lesion in the brain. Does the patient turn his head and eyes? If so, to what side? Where does movement first start? Does it spread? Because a partial seizure may become generalized, you’ll need to watch closely for loss of consciousness, bilateral tonicity and clonicity, cyanosis, tongue biting, and urinary incontinence. (See “Seizures, generalized tonic-clonic,” page 598.)
After the seizure, ask the patient to describe exactly what he remembers, if anything, about the seizure. Then obtain a history. Ask the patient what happened before the seizure. Can he describe an aura or did he recognize its onset? If so, how — by a smell, a visual disturbance, or a sound or visceral phenomenon, such as an unusual sensation in his stomach? How does this seizure compare with others he has had?
Also, explore fully any history, recent or remote, of head trauma. Check for a history of stroke or recent infection, especially with fever, headache, or a stiff neck.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Seizures, simple partial:
History and physical examination
(Nursing: Interpreting Signs and Symptoms)
Be sure to record the patient's seizure activity in detail; your data may be critical in locating the lesion in the brain. Does the patient turn his head and eyes? If so, to what side? Where does movement first start? Does it spread? Because a partial seizure may become generalized, you'll need to watch closely for loss of consciousness, bilateral tonicity and clonicity, cyanosis, tongue biting, and urinary incontinence. (See “Seizures, generalized tonic-clonic,” page 552.)
After the seizure, ask the patient to describe exactly what he remembers, if anything, about the seizure. Check the patient's LOC, and test for residual deficits (such as weakness in the involved extremity) and sensory disturbances.
Then obtain a history. Ask the patient what happened before the seizure. Can he describe an aura or did he recognize its onset? If so, how—by a smell, a vision disturbance, or a sound or visceral phenomenon such as an unusual sensation in his stomach? How does this seizure compare with others he has had?
Also, explore fully any history—recent or remote—of head trauma. Check for a history of stroke or recent infection, especially with fever, headache, or stiff neck.
Perform a complete neurologic examination.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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