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Dysphagia, Neck mass, Lymphnodes, Scoliosis, & Lip Swelling!

2K views 6 replies 5 participants last post by  tyagee 
#1 ·
A 12-year-old girl presents to the pediatrician complaining of difficulty swallowing for the past few months. Her mother also noticed that her daughter’s lips looked swollen and she had developed small, yellowish white, painless bumps on her tongue, lips, and eyelids. On physical examination, the pediatrician detects an irregular-shaped, nontender 4- × 5-cm mass on the right anterior aspect of the neck in addition to multiple palpable cervical lymph nodes. There is also a localized pruritic rash over her upper back. Upon further questioning, the patient revealed that she was diagnosed with scoliosis at age 7, and she was hospitalized 2 years ago with a bowel obstruction but otherwise has no other past medical problems. Based on this information, which of the following is the most appropriate screening test for this condition?

A. Genetic testing
B. Measurement of basal serum calcitonin levels
C. Measurement of serum calcium and parathyroid hormone (PTH) levels
D. Measurement of serum gastrin after secretin stimulation
E. Measurement of urinary catecholamines
 
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