{"id":4139,"date":"2024-07-31T17:25:00","date_gmt":"2024-07-31T17:25:00","guid":{"rendered":"https:\/\/www.osmosis.org\/blog\/?p=4139"},"modified":"2025-10-01T11:38:22","modified_gmt":"2025-10-01T19:38:22","slug":"usmle-step-1-question-of-the-day-somatostatin-analog","status":"publish","type":"post","link":"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-somatostatin-analog","title":{"rendered":"USMLE\u00ae Step 1 Question of the Day: Somatostatin analog"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_80 ez-toc-wrap-center counter-hierarchy ez-toc-counter ez-toc-custom ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">In This Article<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-somatostatin-analog\/#The_correct_answer_to_todays_USMLE%C2%AE_Step_1_Question_is%E2%80%A6\" >The correct answer to today&#8217;s USMLE\u00ae Step 1 Question is&#8230;<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-somatostatin-analog\/#Incorrect_Answer_Explanations\" >Incorrect Answer Explanations<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-somatostatin-analog\/#Main_Explanation\" >Main Explanation<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-somatostatin-analog\/#Major_Takeaway\" >Major Takeaway<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-somatostatin-analog\/#References\" >References<\/a><\/li><\/ul><\/nav><\/div>\n\n<p class=\"wp-block-paragraph\"><em><strong>Test your knowledge with this USMLE Step 1 Question of the Day! A 50-year-old woman presents with daily diarrhea, skin flushing, and shortness of breath. She is treated with a somatostatin analog. Which medication was provided?<\/strong><\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A 50-year-old woman comes to the physician to evaluate diarrhea and skin flushing. The patient has had almost daily episodes of diarrhea, which sometimes awaken her at night. She also notices that her skin turns red every time she drinks alcohol, and these episodes last around 20 minutes. The patient has also experienced intermittent shortness of breath and wheezing, which she attributes to seasonal allergies. Past medical history is notable for hypertension, anxiety, and seasonal allergies. She has had irregular menstrual cycles for the past four months. She does not take any medications. Vitals are within normal limits. Physical examination is noncontributory. The patient is provided a somatostatin analog for treatment. Which of the following medications was provided?&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>A.&nbsp;Octreotide<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>B.&nbsp;Glucagon<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>C.&nbsp;Growth hormone&nbsp;<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>D.&nbsp;Diphenhydramine&nbsp;<\/strong><strong>E.&nbsp;Aspirin&nbsp;&nbsp;<\/strong><\/p>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\">Scroll down for the correct answer!<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"The_correct_answer_to_todays_USMLE%C2%AE_Step_1_Question_is%E2%80%A6\"><\/span>The correct answer to today&#8217;s USMLE\u00ae Step 1 Question is&#8230;<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>A.\u00a0Octreotide<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Before we get to the Main Explanation, let&#8217;s look at the incorrect answer explanations. Skip to the bottom if you want to see the correct answer right away!<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Incorrect_Answer_Explanations\"><\/span>Incorrect Answer Explanations<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>B.\u00a0Glucagon\u00a0<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:<\/strong>&nbsp;Glucagon is the primary catabolic hormone in the body, it is not a somatostatin analog.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>C.\u00a0Growth hormone\u00a0<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:<\/strong>&nbsp;Growth hormone&nbsp;is not a somatostatin analog, nor is it used to treat patients with carcinoid syndrome.&nbsp;&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>D.\u00a0Diphenhydramine\u00a0<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:<\/strong>&nbsp;Diphenhydramine is a first-generation antihistamine. Although diphenhydramine can treat seasonal allergies, this medication is not used to treat carcinoid syndrome.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>E.\u00a0Aspirin\u00a0<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:<\/strong>&nbsp;Aspirin can be used to manage flush associated with niacin use. Aspirin, however, has no role in the management of carcinoid syndrome.&nbsp;&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Main_Explanation\"><\/span>Main Explanation<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Carcinoid tumors&nbsp;are neuroendocrine tumors that arise from&nbsp;enterochromaffin cells. They most often occur in the&nbsp;small intestines&nbsp;but can also develop in the appendix, pancreas, and lungs.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Carcinoid tumors produce excess&nbsp;serotonin. Most serotonin is transported to the liver via portal circulation and broken down by first-pass hepatic metabolism. Therefore, the serotonin does not reach the systemic circulation to cause symptoms. However,&nbsp;carcinoid syndrome&nbsp;develops when serotonin escapes first-pass hepatic metabolism and enters the systemic circulation, such as when cancer&nbsp;metastasizes to extraintestinal sites&nbsp;(e.g. liver).&nbsp;&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Clinical features of carcinoid syndrome are due to serotonin\u2019s effects on various tissues. Serotonin stimulates gut motility in the gastrointestinal tract, resulting in secretory&nbsp;diarrhea. In the skin, serotonin\u2019s vasodilatory effects cause&nbsp;skin flushing, lasting anywhere from 30 seconds to 30 minutes. The flushing can be precipitated by emotional or physical stress and alcohol use. In the lungs, serotonin causes bronchoconstriction, leading to&nbsp;wheezing&nbsp;and&nbsp;dyspnea. Finally, serotonin stimulates fibroblast growth in cardiac tissues, resulting in plaque-like fibrous deposits on the valves, cardiac chambers, and major vessels. These cardiac effects are mainly seen in the right heart and can lead to&nbsp;heart failure&nbsp;and&nbsp;valvular disease.&nbsp;<\/p>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"846\" height=\"438\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/carcinoid-syndrome.png\" alt=\"VASODIALATION\nIncrease in histamine\nIncrease in bradykinin\n-&gt; Flushing\nIncrease in Serotonin\nFibrosis -&gt; Pulmonary stenosis, tricuspid regurgitation\nBronchoconstriction\n* Asthma\n* Shortness of breath \n* Wheezing\nTryptophan -&gt; decrease niacin (Vitamin B3) -&gt; Pellagra\" class=\"wp-image-4141\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/carcinoid-syndrome.png 846w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/carcinoid-syndrome.png?resize=300,155 300w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/carcinoid-syndrome.png?resize=768,398 768w\" sizes=\"auto, (max-width: 846px) 100vw, 846px\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">Histologically, carcinoid tumor cells are arranged in trabeculae or nests. Cells have eosinophilic cytoplasm and round\/oval nuclei filled with fine granules. Like many other neuroendocrine tumors, immunostaining is positive for&nbsp;chromogranin&nbsp;and&nbsp;synaptophysin.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Carcinoid syndrome can be treated with&nbsp;surgical resection&nbsp;and&nbsp;somatostatin analogs, such as octreotide. Somatostatin receptors are highly expressed in the tumor cells. As a result, somatostatin analogs can control symptoms, reduce tumor growth, and improve patient survival.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Major_Takeaway\"><\/span>Major Takeaway<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Carcinoid syndrome&nbsp;is caused by excess&nbsp;serotonin&nbsp;production by a carcinoid tumor. Clinical symptoms may include&nbsp;diarrhea, intermittent&nbsp;skin flushing,&nbsp;wheezing, dyspnea, and&nbsp;heart failure. The condition can be treated with&nbsp;surgical resection&nbsp;and&nbsp;somatostatin analogs, such as octreotide.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"References\"><\/span>References<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Cingam, S.R., Kashyap, S., Karachi, H. (2020) \u201cCarcinoid tumors\u201d.&nbsp;StatPearls [Internet]. Web Address:&nbsp;<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK448101\/\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK448101\/<\/a>.&nbsp;&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Pinchot, S.N., Holen, K., Sippel, R.S., Chen, H. (2008) Carcinoid tumors.&nbsp;The Oncologist. 13(12), 1255-1269. Doi: 10.1634\/theoncologist.2008-0207.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><em>&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;________________________<\/em><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><em><strong>Want more USMLE\u00ae Step 1 practice questions? Try Osmosis by Elsevier today! Access your&nbsp;<em><strong><a href=\"https:\/\/www.osmosis.org\/login?type=create\" target=\"_blank\" rel=\"noreferrer noopener\">free trial<\/a><\/strong><\/em>&nbsp;and find out why millions of current and future clinicians and caregivers love learning with us.<\/strong><\/em><\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><a href=\"https:\/\/www.osmosis.org\/ultimate-guide\/usmle-step-1\" target=\"_blank\" rel=\"noreferrer noopener\"><img loading=\"lazy\" decoding=\"async\" width=\"700\" height=\"250\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/the-ultimate-guide-usmle-step-1-banner.png?w=700\" alt=\"The Ultimate Guide to the USMLE Step 1: Everything you need to know\" class=\"wp-image-760\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/the-ultimate-guide-usmle-step-1-banner.png 700w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/the-ultimate-guide-usmle-step-1-banner.png?resize=300,107 300w\" sizes=\"auto, (max-width: 700px) 100vw, 700px\" \/><\/a><figcaption class=\"wp-element-caption\"><em><em><sub>The United States Medical Licensing Examination (USMLE\u00ae) is a joint program of the Federation of State Medical Boards (FSMB\u00ae) and National Board of Medical Examiners (NBME\u00ae). Osmosis is not affiliated with NBME nor FSMB.&nbsp;<\/sub><\/em><\/em><\/figcaption><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Test your knowledge with this USMLE Step 1 Question of the Day! A 50-year-old woman presents with daily diarrhea, skin flushing, and shortness of breath. She is treated with a somatostatin analog. Which medication was provided? A 50-year-old woman comes to the physician to evaluate diarrhea and skin flushing. The patient has had almost daily [&hellip;]<\/p>\n","protected":false},"author":202,"featured_media":4140,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_post_was_ever_published":false},"categories":[27,20,16,1366,1369,44],"tags":[],"class_list":["post-4139","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medicine","category-exam-prep","category-do","category-questions","category-step-1-questions","category-step-1"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.6 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>USMLE\u00ae Step 1 Question of the Day: Somatostatin analog - Osmosis Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-somatostatin-analog\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"USMLE\u00ae Step 1 Question of the Day: Somatostatin analog - Osmosis Blog\" \/>\n<meta property=\"og:description\" content=\"Test your knowledge with this USMLE Step 1 Question of the Day! A 50-year-old woman presents with daily diarrhea, skin flushing, and shortness of breath. She is treated with a somatostatin analog. Which medication was provided? A 50-year-old woman comes to the physician to evaluate diarrhea and skin flushing. The patient has had almost daily [&hellip;]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-somatostatin-analog\" \/>\n<meta property=\"og:site_name\" content=\"Osmosis Blog\" \/>\n<meta property=\"article:published_time\" content=\"2024-07-31T17:25:00+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2025-10-01T19:38:22+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/usmle-somatostatin-analog.webp\" \/>\n\t<meta property=\"og:image:width\" content=\"1080\" \/>\n\t<meta property=\"og:image:height\" content=\"1080\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/webp\" \/>\n<meta name=\"author\" content=\"Marina Horiates Kerekes, MD &amp; Team\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":[\"Article\",\"BlogPosting\"],\"@id\":\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-somatostatin-analog#article\",\"isPartOf\":{\"@id\":\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-somatostatin-analog\"},\"author\":{\"name\":\"Marina Horiates Kerekes, MD &amp; 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A 50-year-old woman presents with daily diarrhea, skin flushing, and shortness of breath. She is treated with a somatostatin analog. Which medication was provided? A 50-year-old woman comes to the physician to evaluate diarrhea and skin flushing. 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