Gastrointestinal surgery: Menetrier disease: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Gastrointestinal surgery: Menetrier disease

Sample item

A 50-year-old man has epigastric pain, vomiting and pedal oedema. Endoscopy shows giant convoluted folds in the gastric fundus and body with sparing of the antrum. Serum albumin is low and the gastric pH is high. What is the most likely diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Menetrier disease

Menetrier disease is hypertrophic gastropathy with foveolar hyperplasia, loss of parietal cells and hypochlorhydria. Protein is lost through the mucosa, causing hypoalbuminaemia and oedema, and the folds spare the antrum. Zollinger-Ellison syndrome also enlarges folds but with marked acid hypersecretion.

Option by option

  • A. Zollinger-Ellison syndrome

    Zollinger-Ellison syndrome gives acid hypersecretion with a low gastric pH and peptic ulceration, not a high pH.

  • B. Gastric lymphoma

    Gastric lymphoma causes an ulcerating or infiltrating mass and does not typically spare the antrum with protein loss.

  • C. Menetrier disease (correct)

    Correct. Giant rugal folds with protein loss and low acid output suggest Menetrier disease.

  • D. Linitis plastica

    Linitis plastica gives a rigid, non-distensible stomach with loss of folds, not giant folds.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is C, Menetrier disease. Menetrier disease is hypertrophic gastropathy with foveolar hyperplasia, loss of parietal cells and hypochlorhydria.

Why is "Zollinger-Ellison syndrome" not the answer?

Zollinger-Ellison syndrome gives acid hypersecretion with a low gastric pH and peptic ulceration, not a high pH.

Why is "Gastric lymphoma" not the answer?

Gastric lymphoma causes an ulcerating or infiltrating mass and does not typically spare the antrum with protein loss.

Why is "Linitis plastica" not the answer?

Linitis plastica gives a rigid, non-distensible stomach with loss of folds, not giant folds.

What concept does this question test?

It tests Gastrointestinal surgery: Menetrier disease in General Surgery. Protein is lost through the mucosa, causing hypoalbuminaemia and oedema, and the folds spare the antrum. Zollinger-Ellison syndrome also enlarges folds but with marked acid hypersecretion.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Gastrointestinal surgery: Menetrier disease?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.