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CASE 6

CASE 6. White Male With Red Face. A 43 year old white male comes to you 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.

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CASE 6

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  1. CASE 6 White Male With Red Face

  2. A 43 year old white male comes to you 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. (Fecal Occult Blood)

  3. ACTH Gastrin Urinary 5-hydroxyindoleactic acid urinary 5-hydroxyindoleactic acid. The most informative test in this case would be 5-HIAA. Which Test?

  4. the patient must not eat which of the following? Meat Broccoli Bananas Bananas. Also, pineapple, kiwi, eggplant, plums, tomatoes avocados walnuts and other nuts can increase HIAA levels and must therefore not be ingested before measuring Before Urine Test

  5. 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: • Bronchoscopy • GI series and endoscopy • Cystoscopy

  6. GI series and endoscopy • The patient had an ulcerated submucosal mass in the duodenum measuring about 3cm.

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