Rosh Internal Medicine Boost Practice Exam

In a patient with sudden diarrhea and flushing episodes, which finding on imaging could indicate a carcinoid tumor?

1. Calcium deposits in soft tissue

2. Atelectasis of the lung bases

3. Mass lesion in the abdomen

4. Bowen's junctional melanoma

The correct answer is: Atelectasis of the lung bases

In the context of this question, the imaging finding that can indicate a carcinoid tumor, particularly when considering its potential to cause systemic symptoms like diarrhea and flushing, is atelectasis of the lung bases. Carcinoid tumors, which are neuroendocrine tumors most often found in the gastrointestinal tract, can metastasize to the lungs. When they spread to the lung tissue, they can cause obstructive pneumonia or atelectasis due to blockage of airways by the tumor or associated mucus. This finding can be significant when assessing a patient for potential carcinoid syndrome, which encompasses symptoms such as flushing and diarrhea due to the release of bioactive substances like serotonin. The other choices listed do not have the direct association with carcinoid tumors. Calcium deposits in soft tissue are typically related to a variety of other conditions and are not specific to carcinoid tumors. A mass lesion in the abdomen may suggest a number of abdominal tumors but is not specific to carcinoid tumors alone. Bowen's junctional melanoma is a skin condition entirely unrelated to the presence of a carcinoid tumor and does not present any systemic symptoms typically associated with the neuroendocrine tumor syndromes. Therefore, identifying atelectasis in the lungs during