424) A 30 year old man presents to the emergency room with complaints of right lower extremity swelling and pain over the past two days. He has had recurrent diarrhea with loose, watery bowel movements for several weeks without any blood in it. He also reports developing a red, scaly rash around his nose, mouth , genital area and on the buttocks. He has itching and pain in the areas affected by the rash. He denies any fever or night sweats or weightloss. He does not drink alcohol. He is sexually active with his girl friend and always uses condoms. On examination, his vitals are stable. Cardiac and respiratory examination is normal. There is angular cheilitis. Laboratory investigations reveals a normocytic, normochromic anemia. Stool analysis does not show any leucocytes or blood and is negative for ova and parasites. Venous doppler reveals right lower extremity deep vein thrombosis extending up to common femoral vein. Skin examination shows findings as below:
In addition to starting anticoagulation, which of the following should be performed next?
A) Serum Zinc Level
B) CT scan of the abdomen
C) Protein C and S levels
D) Serum Glucagon Levels
E) Factor V leiden mutation
D) Serum Glucagon Levels
why ans is d?
E
B
e, 4% to 6% of the U.S. population
D.
Venous thrombosis occurs in up to 30 percent of patients with glucagonoma. ans is CT
c
D
c
Sorry meant D glucagon
D
C. Protein c and s level
So the skin condition s necrolytic migratory erythema, he also has diarrhea + anaemia of chronic disease+ DVT, findings almost consistent with Glucagonoma , answer: serum glucagon levels followed by CT abdomen.
Noorulain Khan , perfect
serum glucagon level,its nerolytic migratory erythema associated with glucagonoma in 70% cases
d/c glucagonoma, pedir CT. Rp. D
Ans: E
Age -30 years old.Venous doppler reveals right lower extremity deep vein thrombosis extending up to common femoral vein.
Thank you Galaxy !
its D, check Glucagon levels, possibility of Glucagonoma.
c
answer is c..
Is the answer C?
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d
Glucagon level must be checked.
I think the option B. We have to discarded a Glucagonoma.
D
doall
Doesn,t Glucagon only interact with oral anticoagulants.
Sorry…don’t know what u r talking about…but this is Glucagonoma and is associated with increased risk of DVT (as with all cancers i guess) the rash is Necrolytic Migratory Erythema