Endocrine Case: White Male With Red Face
 
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his 43 year old white male comes to his physician with the chief complaint of flushing of the face, watery diarrhea .The physical exam reveals a medium built white male with redness of the face, increased intestinal sounds, and malar telangiectasias. Thoracic exam reveals wheezing and the cardiac exam reveals tricuspid regurgitation. His laboratory tests only reveal increased glucose in serum and glucose intolerance. Stool reveals 5+ guaic.

Your Diagnosis ?

  1. ACTH
  2. Gastrin
  3. Urinary 5-hydroxyindoleactic acid

Before the test the patient must not eat which of the following?

  1. Meat
  2. Broccoli
  3. Bananas

Our patient had 45mg of 5-HIAA in 24 hour urine as well increased serum serotonin after a diet free of the items mentioned in this page. Now, what is your recommendation:

  1. Bronchoscopy
  2. GI series and endoscopy
  3. Cystoscopy

You would now: (answer)

  1. Biopsy the mass
  2. Iodine uptake
  3. MRI

You would now order which of the following stains?

  1. Silver GMS
  2. Chromogranin
  3. PAS

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