Small bowel: carcinoid syndrome: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

General Surgery · Small bowel: carcinoid syndrome

Sample item

A man with episodic flushing, diarrhoea and wheeze has a small ileal mass and multiple liver metastases. Which investigation is the best biochemical marker?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. 24-hour urinary 5-hydroxyindoleacetic acid

Carcinoid syndrome arises when serotonin from a midgut neuroendocrine tumour escapes hepatic metabolism, so it nearly always implies liver metastases. Urinary 5-HIAA, the serotonin metabolite, is raised. Octreotide is used for symptom control.

Option by option

  • A. Serum CA 19-9

    CA 19-9 is used for pancreaticobiliary cancers.

  • B. 24-hour urinary 5-hydroxyindoleacetic acid (correct)

    Correct. Urinary 5-HIAA reflects serotonin production.

  • C. Urinary vanillylmandelic acid

    VMA is measured in phaeochromocytoma and neuroblastoma.

  • D. Serum alpha-fetoprotein

    AFP is a marker for hepatocellular carcinoma and germ cell tumours.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Surgery questions

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is B, 24-hour urinary 5-hydroxyindoleacetic acid. Carcinoid syndrome arises when serotonin from a midgut neuroendocrine tumour escapes hepatic metabolism, so it nearly always implies liver metastases.

Why is "Serum CA 19-9" not the answer?

CA 19-9 is used for pancreaticobiliary cancers.

Why is "Urinary vanillylmandelic acid" not the answer?

VMA is measured in phaeochromocytoma and neuroblastoma.

Why is "Serum alpha-fetoprotein" not the answer?

AFP is a marker for hepatocellular carcinoma and germ cell tumours.

What concept does this question test?

It tests Small bowel: carcinoid syndrome in General Surgery. Urinary 5-HIAA, the serotonin metabolite, is raised. Octreotide is used for symptom control.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Small bowel: carcinoid syndrome?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.