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A 45-year-old man with a personal and family history of nephrocalcinosis

45 years old | Male

Vignette:

A 45-year-old man with a personal and family history of nephrocalcinosis presents to his family medicine doctor with recurrent epigastric pain associated with bloating and diarrhea. He is started empirically on an oral proton-pump inhibitor and notes improvement in the frequency and quantity of diarrhea, although he continues to experience epigastric pain.

Summary:

nephrocalcinosis | recurrent epigastric pain | bloating | diarrhea | oral proton-pump inhibitor

Dx:

Zollinger-Ellison Syndrome Gastrinoma

Ref:

https://online.epocrates.com/diseases/40822/Zollinger-Ellison-syndrome/Common-Vignette

Rank

Disease

Weight

1 Giardiasis 217.0
2 Duodenal Ulcer 157.0
3 Gastric Ulcer 157.0
4 Hereditary Angioedema 153.0
5 Intestinal Entamoeba histolytica amebiasis 150.0
6 Zollinger-Ellison Syndrome 149.0
7 Acute peptic ulcer 147.0
8 Sigmoid volvulus 147.0
9 Gastric Outlet Obstruction 146.0
10 Intestinal Pseudo Obstruction 145.0
11 Ovarian Cancer 143.0
12 Gastroparesis 142.0
13 Hemolytic uremic syndrome 142.0
14 Lactose intolerance 141.0
15 Food poisoning 139.0
16 Mesenteric ischemia 137.0
17 Premenstrual syndrome 134.0
18 Dyspepsia 133.0
19 Irritable Bowel Syndrome 132.0
20 Bacterial gastroenteritis 130.0
21 Sarcoidosis 127.0
22 Crohn Disease 127.0
23 Non-cholera Vibrio infections 127.0
24 pancreatic cancer 126.0
25 Celiac Disease 125.0
26 Ruptured ectopic pregnancy 121.0
27 mucosal Eosinophilic gastroenteritis 116.0
28 Analgesic nephropathy 106.0
29 Diverticulitis 106.0
30 Hyperparathyroidism 103.0
31 Systemic sclerosis 103.0
32 Acute Pancreatitis 101.0
33 Acute Cholecystitis 101.0
34 Emphysematous cholecystitis 101.0
35 Intussusception 101.0
36 Acute perforated appendicitis 100.0
37 Chronic Pancreatitis 100.0
38 Peptic Ulcer 99.0
39 Eosinophilic gastroenteritis 97.0
40 Anal Fissure 95.0
41 Listerial gastroenteritis 94.0
42 Muscle Layer Eosinophilic gastroenteritis 92.0
43 subserosal eosinophilic gastroenteritis 92.0
44 Systemic lupus erythematosus 92.0
45 Abdominal compartment syndrome 91.0
46 Alcoholic hepatitis 89.0
47 Hiatus hernia 89.0
48 Gallstone pancreatitis 89.0
49 Acute viral meningitis 86.0
50 Cystic Fibrosis 85.0
51 Malaria 85.0
52 Gastritis 84.0
53 Short bowel syndrome 84.0
54 Travelers diarrhea 84.0
55 Abetalipoproteinemia 84.0
56 Salmonella infection 84.0
57 Gastric cancer 83.0
58 Bacterial pharyngitis 83.0
59 Extraintestinal Entamoeba histolytica amebiasis 82.0
60 Anthrax 79.0
61 Leiomyomas 78.0
62 Primary sclerosing cholangitis 76.0
63 Diabetes Mellitus 76.0
64 Type 2 Diabetes mellitus 76.0
65 Type 1 Diabetes mellitus 76.0
66 Ulcerative Colitis 75.0
67 Viral Gastroenteritis 75.0
68 Gastric Volvulus 73.0
69 Chronic Myeloid Leukemia 73.0
70 Acute Appendicitis 72.0
71 Choledocholithiasis 72.0
72 Cholera 72.0
73 biliary colic 71.0
74 Primary biliary cirrhosis 70.0
75 Ascites 69.0
76 Osteoporosis 69.0
77 Liver disease 68.0
78 Liver Cirrhosis 68.0
79 Biliary cirrhosis 68.0
80 Graves Disease 67.0
81 biliary SOD 66.0
82 Brucellosis 66.0
83 Prostatitis 66.0
84 Chronic prostatitis 66.0
85 Acute Bacterial Prostatitis 66.0
86 Chronic bacterial prostatitis 66.0
87 Foodborne E coli infection 65.0
88 Gastrointestinal Hemorrhage 65.0
89 Lower gastrointestinal hemorrhage 65.0
90 Upper gastrointestinal hemorrhage 65.0
91 Globus Sensation 65.0
92 Gallstones 64.0
93 Choledochal Cyst 64.0
94 Hyperthyroidism 64.0
95 Foreign body ingestion 63.0
96 Henoch-Schonlein purpura 63.0
97 Malt lymphoma 61.0
98 Campylobacter infection 61.0
99 Spontaneous bacterial peritonitis 61.0
100 Hepatocellular carcinoma 60.0
101 Ovarian Hyperstimulation Syndrome 60.0
102 Kawasaki disease 60.0
103 Chronic pelvic pain in women 59.0
104 Gastroenteritis 59.0
105 Meckel diverticulum 58.0
106 Familial Mediterranean fever 58.0
107 Secondary Peritonitis 57.0
108 Amebic Liver Abscess 57.0
109 Alcoholic Liver Disease 57.0
110 Peutz-Jeghers Syndrome 56.0
111 Painless thyroiditis 56.0
112 Biliary cyst 55.0
113 Acalculous Cholecystitis 54.0
114 chronic acalculous cholecystitis 54.0
115 Tuberculous Peritonitis 54.0
116 Exocrine pancreatic insufficiency 54.0
117 Ovarian Torsion 54.0
118 Rumination Syndrome 54.0
119 Thrombotic thrombocytopenic purpura 54.0
120 Polyarteritis nodosa 53.0
121 Amyloidosis 53.0
122 Intraperitoneal bleeding 53.0
123 Alcoholic Liver Cirrhosis 53.0
124 Amebiasis 53.0
125 Sphincter of Oddi Dysfunction 51.0
126 pancreatic SOD 51.0
127 Intestinal Obstruction 50.0
128 Ileus 50.0
129 Alcoholic Fatty Liver 50.0
130 Umbilical hernia 50.0
131 Peritoneal dialysis associated peritonitis 50.0
132 Anaphylaxis 50.0
133 Pheochromocytoma 50.0
134 Diabetic Amyotrophy 50.0
135 Multiple Sclerosis 50.0
136 Acute intermittent porphyria 49.0
137 Autoimmune Pancreatitis 48.0
138 Autoimmune hepatitis 48.0
139 Acute Liver Failure 48.0
140 Acute bacterial meningitis in children 47.0
141 Intra-abdominal abscess 46.0
142 Hypogammaglobulinemia 46.0
143 Hyperprolactinemia 46.0
144 Cholangiocarcinoma 45.0
145 Colorectal cancer 44.0
146 Klebsiella pneumoniae liver abscess 44.0
147 Endometrial cancer 44.0
148 Acute otitis media 44.0
149 Chronic Milk-alkali syndrome 43.0
150 Cholecystitis 43.0
151 Gallbladder Dyskinesia 43.0
152 Chronic Cholecystitis 43.0
153 Preeclampsia 43.0
154 COPD Exacerbation 43.0
155 Autosomal Dominant Polycystic Kidney Disease 41.0
156 Addison Disease 41.0
157 Milk-alkali syndrome 40.0
158 Acute Milk-alkali syndrome 40.0
159 Chronic Clonorchiasis 40.0
160 Familial adenomatous polyposis syndrome 40.0
161 Heparin-induced thrombocytopenia 40.0
162 Inguinal hernia 40.0
163 Chronic Hepatitis 40.0
164 Multiple endocrine neoplasia 2A 39.0
165 Intestinal malrotation 38.0
166 Bruxism 38.0
167 Erectile dysfunction 38.0
168 Annular pancreas 37.0
169 Diabetic Neuropathy 36.0
170 Wilson disease 36.0
171 Multiple endocrine neoplasia 2B 36.0
172 STI HIV Pharyngitis 36.0
173 Hypercalcemia 35.0
174 Gastroesophageal reflux disease 35.0
175 Inflammatory Bowel Diseases 35.0
176 Endometriosis 35.0
177 Bladder Cancer 35.0
178 Urinary Tract Obstruction 34.0
179 Acute heart failure 34.0
180 Acute Lymphoblastic leukemia in children 34.0
181 Ruptured Tuboovarian abscess 34.0
182 Stevens-Johnson syndrome 34.0
183 Aseptic meningitis 34.0
184 Acute fatty liver of pregnancy 33.0
185 Hypothyroidism 33.0
186 Churg-Strauss Syndrome 33.0
187 Atopic dermatitis 33.0
188 Pancreatic Pseudocyst 32.0
189 Ankylosing spondylitis 32.0
190 Acromegaly 31.0
191 Disseminated intravascular coagulation 30.0
192 Medullary thyroid cancer 30.0
193 Clostridium difficile infection 29.0
194 Chronic Lymphocytic Leukemia 29.0
195 Blepharitis 29.0
196 Hepatorenal Syndrome 28.0
197 Adrenal crisis 28.0
198 Hypertriglyceridemia 27.0
199 Graves ophthalmopathy 27.0
200 Tinea versicolor 27.0
201 COVID19 25.0
202 Carpal Tunnel Syndrome 25.0
203 Primary Myelofibrosis 24.0
204 Hereditary hemochromatosis 24.0
205 Allergic rhinitis 24.0
206 Abnormal uterine bleeding 24.0
207 Mallory-Weiss syndrome 23.0
208 Common cutaneous drug reactions 23.0
209 Psoriasis 23.0
210 Ectopic Pregnancy 23.0
211 Acute Lymphocytic Leukemia in Adults 22.0
212 Discogenic low back pain 22.0
213 Parkinson disease 22.0
214 Budd Chiari Syndrome 21.0
215 Pyogenic Liver Abscess 21.0
216 Esophagitis 20.0
217 Chronic liver disease 20.0
218 Portal hypertension 20.0
219 Acute peritonitis 20.0
220 Autosomal Recessive Polycystic Kidney Disease 20.0
221 Chronic Mitral regurgitation 20.0
222 Tuboovarian abscess 20.0
223 Pneumonia 20.0
224 Epidemic keratoconjunctivitis 20.0
225 Acute bacterial meningitis in neonates 20.0
226 Rocky Mountain spotted fever 20.0
227 Acute pericarditis 20.0
228 Acute Myeloid Leukemia in adults 19.0
229 Tinnitus 18.0
230 Atypical pneumonia 18.0
231 Acute Cystitis(Men) 18.0
232 Optic neuritis 18.0
233 Neuropapillitis 18.0
234 Eclampsia 17.0
235 Infectious mononucleosis 17.0
236 Gilbert syndrome 17.0
237 Toxic Megacolon 17.0
238 Non-alcoholic Fatty Liver Disease 17.0
239 Mitral Stenosis 17.0
240 Chronic heart failure 17.0
241 Middle East respiratory syndrome 17.0
242 Gallbladder cancer 16.0
243 Ruptured ovarian cyst 16.0
244 Guillain-Barre syndrome 16.0
245 Migraine headache in adults 16.0
246 Glomerulonephritis 16.0
247 Acute Cholangitis 15.0
248 Acute Clonorchiasis 15.0
249 Shigellosis 15.0
250 Influenza 15.0
251 Bullous pemphigoid 14.0
252 Acetaminophen overdose 13.0
253 Goiter 13.0
254 Diabetic Kidney Disease 13.0
255 Diffuse nontoxic goiter 13.0
256 Toxic multinodular goiter 13.0
257 Obstructive cervical goiters 13.0
258 Cervical goiter 13.0
259 Pyelonephritis 12.0
260 Acute pyelonephritis in adults 12.0
261 ST-elevation myocardial infarction 12.0
262 Gestational diabetes mellitus 12.0
263 Achalasia 12.0
264 Von willebrand disease 12.0
265 Amphetamine use disorder 11.0
266 Kidney stones 10.0
267 Diabetic Ketoacidosis 10.0
268 Herpes zoster 10.0
269 End Stage Renal Disease 10.0
270 Rosacea 10.0
271 Cushing syndrome 10.0
272 Renal Cell Carcinoma 9.0
273 Insomnia in adults 9.0
274 Prolactinoma 9.0
275 Common cold(children) 8.0
276 Endometritis 8.0
277 Common cold(adults) 7.0
278 Psoriatic arthritis 7.0
279 Adrenocortical carcinoma 7.0
280 Peyronie Disease 7.0
281 Menopause 7.0
282 Non-small cell lung cancer 6.0
283 Multiple Myeloma 6.0
284 Liver Abscess 6.0
285 Ramsay Hunt syndrome 6.0
286 Meniere disease 6.0
287 Pelvic inflammatory disease 6.0
288 Acute pelvic inflammatory disease 6.0
289 Limited cutaneous systemic sclerosis 6.0
290 Lung Cancer 5.0
291 Testicular cancer 5.0
292 Thyroid lymphoma 5.0
293 Anaplastic thyroid cancer 5.0
294 Bed bugs 5.0
295 Hemorrhagic stroke 4.0
296 Ischemic stroke 4.0
297 Renal and perinephric abscess 4.0
298 Acute Rhinosinusitis 4.0
299 Panic disorder in adults 4.0
300 Acute viral rhinosinusitis 4.0
301 Acute bacterial rhinosinusitis 4.0
302 Migraine 3.0
303 Alopecia areata 2.0
304 Acute Bronchitis 2.0
305 Typhoid infection 2.0
306 Chlamydia pneumoniae infection 2.0
307 Acute Hepatitis 2.0
308 Primary ciliary dyskinesia 2.0
309 Kartagener syndrome 2.0
310 Granulomatosis with polyangiitis 1.0
311 Rheumatoid Arthritis 1.0
312 Immune thrombocytopenia 0.0
313 Hemorrhoids 0.0
314 Motion Sickness 0.0
315 Recurrent aphthous stomatitis 0.0
316 Myasthenia Gravis 0.0
317 Congenital Myasthenic Syndromes 0.0
318 Neonatal Myasthenia Gravis 0.0
319 Insect bites and stings 0.0
320 Alzheimer disease 0.0
321 Acute disseminated encephalomyelitis 0.0
322 Bell palsy 0.0
323 Myoclonus 0.0