Characteristics of carcinoid tumors Carcinoid tumors are neuroendocrine tumors of the lung, GI tract, or genitourinary system. They are classified based on their embryonic origin (i.e., foregut, midgut, and hindgut tumors). These tumors convert dietary tryptophan into serotonin. Serotonin is metabolized to 5-hydroxyindoleacetic acid (5-HIAA). Elevated levels of 5-HIAA are diagnostic. These tumors also secrete …
Evaluation and management of neuroendocrine tumors Hormone evaluation based on clinical presentation. Computed tomography scan or magnetic resonance imaging can localize most tumors. Endoscopic ultrasound (i.e., pancreatic tumors) and octreotide scan can be used to localize small tumors. Treatment often involves resection of primary tumor and initiation of somatostatin analogs (i.e., octreotide, lanreotide). Interferon alpha …
clinical presentation of neuroendocrine tumors Neuroendocrine tumors are classified as well-differentiated (i.e., carcinoid tumors, pancreatic islet cell tumors) or as more aggressive, poorly differentiated tumors (i.e., carcinomas). Most are sporadic but can be associated with hereditary syndromes like multiple endocrine neoplasia 1 (MEN1). They typically secrete substances such as chromogranin A and pancreatic polypeptide. They …
Etiology and workup of hypoglycemia in non diabetic patients? Several conditions that can precipitate hypoglycemia including medications (e.g. insulin, sulfonylurea), ethanol use (inhibits gluconeogenesis), malnutrition (lack of substrate), critical illness (increased glucose utilization), renal failure (decreased clearance of insulin) and adrenal insufficiency (loss of cortisol causes increased insulin sensitivity) must be ruled out based on …
How is hypoglycemia diagnosed in patients with and without diabetes? Hypoglycemia is defined by a blood glucose value of less than 70 mg/dL in patients with diabetes. Insulin therapy and other antidiabetic medications that cause low blood sugars are the leading culprits. In patients without diabetes, the following hypoglycemia triad (known as Whipple’s triad) should …
How is hypoglycemia diagnosed in patients with and without diabetes Read More »
What are the gastroenterological complications associated with diabetes? Diabetic complications related to the gastrointestinal (GI) system include constipation, heartburn (i.e., gastroesophageal reflux), delayed gastric emptying (i.e., gastroparesis), dyspepsia, abdominal pain, and watery diarrhea (i.e., diabetic enteropathy). Development of these symptoms is associated with longer duration of diabetes, poor glycemic control, and autonomic neuropathy of the …
therapeutic options available for the treatment of type 2 diabetes? Patients with type 2 diabetes have relative deficiency of both insulin and amylin. Several oral agents have been approved for use in type 2 diabetes. These agents typically increase insulin secretion (i.e., sulfonylureas, GLP-1 analogues, DPP-4 inhibitors), improve insulin sensitivity at target tissues (i.e., thiazolidinediones, …