carcinoid syndrome

Question 1

define carcinoid syndrome

Answer 1

A constellation of symptoms caused by a neuroendocrine tumour secreting excess amounts of neurotransmitters and hormones.

Question 2

describe the formation of a carcinoid tumour

Answer 2

-Slow-growing neuroendocrine tumours arising mostly in the GI tract, appendix, and lungs

Question 3

what do neuroendocrine tumours secrete?

Answer 3

-secrete excess bioactive substances such as serotonin, histamine, bradykinin, and prostaglandins

Question 4

what type of substance is serotonin?

Answer 4

is a vasoactive substance

Question 5

what is serotonin involved in?

Answer 5

involved in the regulation of mood, appetite, and various physiological processes.

Question 6

what does serotonin cause?

Answer 6

Serotonin causes the presenting symptoms of carcinoid syndrome.

Question 7

what are the systemic effects of carcinoid syndrome produced by and what are they?

Answer 7

Elevated levels of serotonin and other bioactive substances lead to symptoms including skin flushing, diarrhoea, abdominal pain, bronchoconstriction, and heart valve damage.

Question 8

describe skin flushing produced during carcinoid syndrome?

Answer 8

Blood vessels near the surface of the skin dilate due to serotonin, leading to reddening of the skin, particularly on the face and upper body.

Question 9

describe how carcinoid syndrome causes diarrhoea and abdominal cramps

Answer 9

Serotonin causes increased motility and secretions of the intestines, leading to diarrhoea.

Question 10

describe how carcinoid syndrome causes bronchoconstriction

Answer 10

• Release of serotonin in the lungs can lead to narrowing of the airways, leading to wheezing and difficulty breathing.

Question 11

describe how carcinoid syndrome produces heart valve damage

Answer 11

Long-term exposure to high levels of serotonin can lead to fibrosis of the heart valves.

Question 12

describe the epidemiology of carcinoid syndrome

Answer 12

-Prevalence- 1-2 cases per 100,000
-Age- Most common in individuals aged 40-60

Question 13

what are the risk factors for carcinoid syndrome?

Answer 13

-Female
-Age
-Patient with a metastatic disease
-Primary Tumour Locations

Question 14

what are the signs of carcinoid syndrome?

Answer 14

-Right-Upper Quadrant Pain
-Bronchoconstriction
-Heart valve damage

Question 15

what are the symptoms of carcinoid syndrome?

Answer 15

-Skin Flushing
-Diarrhoea
-Abdominal pain
-Wheezing
-Difficulty Breathing

Question 16

how do you diagnose carcinoid syndrome?

Answer 16

-High volume of 5-hydroxyindoleacetic acid (breakdown of serotonin) in urine
-Metabolic panel and LFTs
- CT/MRI to locate primary tumour
- Liver ultrasound to confirm metastases

Question 17

how is carcinoid syndrome treated?

Answer 17

-Surgically excise primary tumour
- SST analogue infusion to block tumour hormone release
- For metastases: above + targeted therapies/chemo

Question 18

describe what happens during a carcinoid crisis

Answer 18

A life-threatening event that can occur if carcinoid tumours and especially if carcinoid syndrome is present.

it is a sudden and severe intensification of the symptoms of carcinoid syndrome, triggered by various factors including stress, anaesthesia, or certain medications.

It is a release of large amounts of bioactive substances into the body, overwhelming the regulatory mechanisms.