Clinical Manifestations and Presentation of Diseases — MCQs

Question 361: Which of the following is NOT a characteristic of pancreatic cholera?

• A. Hypocalcemia
• B. Hypokalemia
• C. Glucose intolerance
• D. Hypochlorhydria (Correct Answer)

Explanation: ***Hypochlorhydria*** - Pancreatic cholera (also known as <b>VIPoma</b>) is characterized by massive secretion of <b>vasoactive intestinal peptide (VIP)</b>, which stimulates intestinal fluid and electrolyte secretion [1]. - Unlike **gastrinomas** which cause hyperchlorhydria, VIPomas do not directly affect gastric acid secretion, so <b>hypochlorhydria</b> is not a typical feature. *Hypokalemia* - This is a hallmark of pancreatic cholera due to the large volume of diarrhea, leading to significant **potassium loss** in stool. - The elevated VIP levels stimulate intestinal secretion of electrolytes, including potassium. *Glucose intolerance* - VIP can stimulate **glycogenolysis** and inhibit insulin release, leading to elevated blood glucose levels. - This is a common metabolic disturbance seen in VIPoma patients. *Hypocalcemia* - Although less common than hypokalemia, VIP can significantly increase **intestinal calcium secretion**, leading to calcium loss and subsequent hypocalcemia. - This electrolyte imbalance contributes to the clinical symptoms of pancreatic cholera.