Snapshot A 38-year-old women presents to the emergency department with 1 day of severe flank pain. She also notes that she has had intermittent watery diarrhea for the past few weeks. On physical exam the patient has mild abdominal tenderness to palpation, particularly in the epigastric region and upper left quadrant, as well as costovertebral angle (CVA) tenderness. Lab studies show hypercalcemia and an ultrasound shows the presence of a kidney stone. (Multiple endocrine neoplasia [MEN] type I) Introduction Overview login to view 5 more bullets Genetics login to view 3 more bullets Epidemiology login to view 3 more bullets Prognosis login to view 1 more bullet Classification MEN I (Wermer syndrome) login to view 13 more bullets MEN II login to view 16 more bullets Presentation Symptoms login to view 12 more bullets Physical exam login to view 8 more bullets Imaging Ultrasound of neck login to view 5 more bullets Magnetic resonance imaging (MRI) or computed tomography (CT) scan of abdomen login to view 4 more bullets Studies TSH levels login to view 2 more bullets Serum calcitonin login to view 1 more bullet Free serum metanephrine level login to view 4 more bullets Serum PTH and calcium levels login to view 1 more bullet Serum glucose login to view 2 more bullets Serum glucagon login to view 1 more bullet Serum insulin and C-peptide login to view 1 more bullet Serum gastrin login to view 1 more bullet Treatment Medical login to view 6 more bullets Surgical login to view 21 more bullets