crista
Forum Guru
Topics: 121
Posts: 408
|
A 58-year-old former alcoholic is brought in to the clinic by his wife. She tells you in private that she's worried her husband has begun drinking again because his face ‘is red all the time these days.’ When you speak with the patient, he denies any alcohol use in the last 12 years. He says his only problems are that he's been ‘wheezing a lot lately’ and that his ‘stomach’s been acting up—lots of diarrhea.' The physical exam is normal and vitals are within normal ranges. Routine screening reveals no serum ethanol. However, his liver function tests return abnormal results. Which of the following tests would be the next appropriate diagnostic exam?
A. Barium swallow test
B. Colonoscopy
C. Echocardiogram
D. Liver biopsy
E. Urine metabolite analysis
|
| asmi
Forum Hero
Topics: 1043
Posts: 4,609
|
anne :icon_salut: you are right.
Since he is flushing all the time" red face", he is an alcoholic .
It points towards carcinoid syndrome = diarrohea+ cutaneous flush+wheezing
Most common site is appendix ( no mets) and second site is terminal ileum( mets to liver )
You have to do urinary 5-HIAA
|
| anne
Forum Elite
Topics: 41
Posts: 348
|
E :?:
may be carcinoid syndrome
|
| crista
Forum Guru
Topics: 121
Posts: 408
|
no,it's E but i don't know the disease-porfiria was my answer but from the forum that i took the q was talking about carcinoid...the liver is affected,so i think i'm right... 
|
| Idiopathic
Forum Guru
Topics: 19
Posts: 641
|
Yeah, i picked E also. It is definitely the clinical picture of carcinoid. Remember, no systemic disease unless liver involved (i.e. appendiceal carcinoid tumors are often incidental findings at autopsy and not contribute to disease).
You could probably pick the least invasive test if you got stuck tho
|
|
| |
| | | | | |
