Question 17
A 45 year old Caucasian male is brought to the ER with complaints of breathlessness since few hours. He gives complaints of flushing and dermatitis since few days. Lately, he noticed he gets flushing and increase in number of bowel movements daily which are watery in consistency. He is not able to recall the exact time since the symptoms began. He has a rash around his collar. He vitals are stable except he is breathing heavily. On respiratory examination, he has wheezing all over. He complains of pain in upper abdomen. What is the most likely diagnosis?
A) Vitamin deficiency
B) Food Poisoning
C) Asthmatic attack
D) Serotonin tumor
E) Inflammatory bowel disease.
Answer will be posted under comments section soon.
3 comments:
serotonin tumour
why serotonin tumor please, i thought the frequent bowel movt,dermatitis n being unable to recall was supposed to point us towards pallegra (Vit B3 deficiency)
This would more accurately be malignant carcinoid tumor. carcinoid tumors are known to produce various vasoactive amines including serotinin. This patient has carcinoid syndrome which has metastasised to liver which causes carcinoid syndrome. All the symptoms in this patient viz diarrhoea, flushing of skin( Vasodilation), Pruritis, breathlessness, can be explained by that.
Also excess serotonin production causes causes depletion of tryptophan from which niacin is synthesised, which explains the deficiency of niacin in this patient ( ANS to question no. 19)
Post a Comment