PAEA Surgery End Of Rotation (EOR) Practice Exam

Which syndrome is characterized by flushing, diarrhea, and palpitations, with elevated 5-HIAA levels?

1. Carcinoid

2. Hirschsprung

3. Dumping syndrome

4. Menetrier's disease

The correct answer is: Carcinoid

The correct answer is characterized by flushing, diarrhea, and palpitations due to the excessive release of serotonin from neuroendocrine tumors known as carcinoid tumors. These tumors typically arise from cells in the gastrointestinal tract, particularly the small intestine, and can metastasize to the liver, which allows for the systemic release of serotonin. Elevated levels of 5-hydroxyindoleacetic acid (5-HIAA) in the urine are a result of increased serotonin production, as 5-HIAA is the main metabolite of serotonin. The presence of these symptoms and laboratory findings together suggests the presence of a carcinoid syndrome, which is specifically associated with carcinoid tumors. In contrast, Hirschsprung disease relates to bowel obstruction due to an absence of ganglion cells in the colon, Dumping syndrome results from rapid gastric emptying that leads to gastrointestinal symptoms after eating, and Menetrier's disease is characterized by gastric hypertrophy and protein loss rather than the hormonal changes seen in carcinoid syndrome. Thus, the combination of symptoms and the laboratory findings of elevated 5-HIAA levels clearly align with carcinoid syndrome.