Wed3November0919PM 17

Regarding carcinoid syndrome, are the following true or false?

True / False

Deranged electrolytes are frequently seen Correct

Urinary bradykinin concentrations may be elevated Correct

It is associated with left sided cardiac valve lesions Incorrect answer selected

Small bowel carcinoid tumours rarely metastasise to the liver Correct

Tumours arise from enterochromaffin cells Correct

Explanation

Carcinoid tumours may secrete:

5 Hydroxytryptamine (5HT)

Bradykinin

Histamine

Substance P, or

Prostaglandins.

The tumours arise in enterochromaffin (argentaffin) cells and produce symptoms when peripheral levels of 5HT, etc, reach high levels.

Thirty six percent are found in the small bowel and metastasise to the liver before causing the syndrome. They are also found in the lung, pancreas, large bowel and stomach.

The classic syndrome is of:

Diarrhoea

Flushing with hypotension

Telangectasia, and

Bronchospasm.

Less commonly hypertension and right-sided heart valve lesions are seen.

A raised urinary 5-hydroxyindoleacetic acid (5HIAA) on a low serotonin diet is diagnostic.

Electrolyte imbalance and malnutrition is seen when diarrhoea is the primary clinical manifestation.

Answer Statistics

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Average score: 70.96%

Times answered: 270