Rosh Internal Medicine Boost Practice Exam

In a 57-year-old woman presenting with diarrhea and facial flushing, which diagnosis is most likely with the finding of left lower lobe atelectasis?

1. Angioedema

2. Carcinoid tumor

3. Cardiac dysrhythmia

4. Irritable bowel syndrome

The correct answer is: Carcinoid tumor

In the context of this question, a carcinoid tumor is associated with the symptoms of diarrhea and facial flushing due to the secretion of serotonin and other vasoactive substances. These neuroendocrine tumors can lead to a condition known as the carcinoid syndrome, characterized by flushing and diarrhea. The presence of left lower lobe atelectasis can also suggest that there might be a mass or obstruction in the bronchial tree due to the tumor, further supporting the diagnosis. Understanding the correlation between the patient's gastrointestinal symptoms and the respiratory findings is critical. The neuroendocrine nature of a carcinoid tumor means it can affect not only the GI tract but also may have respiratory implications, especially if it infiltrates or metastasizes to the lungs, causing secondary complications like atelectasis. While the other options present distinct clinical scenarios, they do not adequately explain the combination of diarrhea, facial flushing, and the finding of left lower lobe atelectasis as effectively as the carcinoid tumor does. Therefore, the symptoms and imaging findings align aptly with the diagnosis of a carcinoid tumor.