DrVirgo
Forum Hero
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A 50 year old woman presents with 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 exam, 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. Lab results are unremarkable. Which of the following is the most appropriate next step in diagnosis?
A. Barium exam of the bowel
B. Measurement of serum lipase adn amylase levels
C. Ultrasound of the abdomen
D. Urinanalysis for 5-HIAA
E. Small bowel biopsy
What do you suspect she has?
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| CocaCola
Forum Guru
Topics: 35
Posts: 908
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carcinoid syndrome
d - urinalysis for 5-HIAA
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| doyoudig
Forum Guru
Topics: 144
Posts: 613
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D. Urinanalysis for 5-HIAA -agree
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| dncosta
Licensed, finally
Topics: 19
Posts: 604
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| prathapdoctor
Forum Elite
Topics: 12
Posts: 406
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I agree with you all, but the most sensitive test is determining levels of chromogranin A.
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| DrVirgo
Forum Hero
Topics: 1096
Posts: 3,514
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D is right.
Flushing, Watery diarrhea, adn valvular heart disease ==> Triad for Carcinoid Syndrome.
Measure 5-HIAA.
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