PAEA Surgery End Of Rotation (EOR) Practice Exam

What triggers are commonly associated with carcinoid syndrome?

1. Food consumption

2. Elaboration of serotonin by tumor

3. Smoking

4. Medication side effects

The correct answer is: Elaboration of serotonin by tumor

Carcinoid syndrome is associated with neuroendocrine tumors that primarily secrete serotonin, leading to a specific set of symptoms. The elaboration of serotonin by the tumor plays a central role in the pathophysiology of carcinoid syndrome. When serotonin is released into the bloodstream, particularly in the presence of liver metastases—where hepatic metabolism is impaired—it can cause a range of effects, including flushing, diarrhea, and bronchospasm. This means that the presence of a tumor that overproduces serotonin is fundamentally what drives the symptoms associated with carcinoid syndrome. Thus, if a patient has a carcinoid tumor, the excessive serotonin production directly leads to the characteristic clinical features, making this the correct answer. In contrast, while food consumption may indeed exacerbate symptoms in some cases due to the release of certain hormones or other factors, it is not a direct trigger of the syndrome itself. Similarly, while smoking and medication side effects might influence general health or trigger other conditions, they do not specifically trigger the biochemical pathway of carcinoid syndrome related to serotonin overproduction.