Question of the Day!

A new patient is complaining of recurrent diarrhea. On exam she presents with cutaneous flushing, asthmatic wheezing (with no hx of asthma), and a new tricuspid murmur. Urinalysis shows increased 5-HIAA. Your diagnosis most likely is?

A) Renal Osteodystrophy
B) Diabetes Insipidus
C) Crohn’s Disease
D) Carcinoid Syndrome
E) MEN type I

















Answer: D) Carcinoid Syndrome. It is caused by tumor consisting of neuroendocrine cells, especially metastatic small bowel tumors. The tumors usually secrete large amounts of Serotonin which results in the symptoms in this patient. Use the ‘Rule of 1/3’: 1/3 metastasize, 1/3 present with 2nd malignancy, and 1/3 are multiple.