A 60-year-old woman presents with a 3-month history of episodic facial flushing, watery diarrhea, and wheezing. Vital signs show BP 128/82 mmHg, HR 102 bpm, RR 18/min, temp 37.2°C, SpO2 98% on room air. CT abdomen reveals a 2-cm small bowel neuroendocrine tumor with multiple hepatic metastases. Serum chromogranin A is elevated at 450 ng/mL. Physical examination shows no hepatomegaly. Which substance best explains her clinical presentation?
- A)Insulin
- B)Somatostatin
- C)Gastrin
- D)Histamine released from mast cells in the skin only
- E)SerotoninGABARITO
Explicação
Carcinoid syndrome is due to secretion of serotonin and other vasoactive substances by a neuroendocrine tumor, usually after liver metastases bypass hepatic metabolism. Flushing, diarrhea, and bronchospasm are classic features, and urinary 5-HIAA is often elev... Ver explicação completa e trilha adaptativa →