ibraheem
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A 50 y-o woman presents with a chief complaint of dizziness when she gets out of bed in the morning.During the episodes of dizziness,she feels very warm and flushed. She admits to frequent episodes of abdominal cramping and severe watery diarrhea during the past year, and she recently began having dry ,itchy skin. on physical examination,she has a 2/6 systolic murmur best heard at the left lower sternal border.No wheezing ,rhonchi,or crackles are apparent on lung examination.laboratory results are unremarkable.Which of the following is the most appropriate next step in diagnosis?
a. Barium examination of the bowel.
b. Measurement of the serum lipase and amylase levels.
c.Ultrasound of the abdomen.
d.Urinalysis for 5-hydroxyindoleacetic acid(5-HIAA)
e. Small bowel biopsy.
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| ARJ
Forum Guru
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d.Urinalysis for 5-hydroxyindoleacetic acid(5-HIAA)
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| phuluong2k
Forum Fanatic
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D too
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| ibraheem
Forum Junior
Topics: 5
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The answer is d.
the women has carcinoid syndrome of which the classic traid is flushing( present in 85%),watery diarrhea,and valvular heart disease.determination of 5-HIAA(metabolites of serotonin,5-HT)in a 24-hour urine sample is the first screening test.
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