Metabolic abnormality seen in large colorectal villous adenoma
**Core Concept**
The question is testing the association between large colorectal villous adenomas and a specific metabolic abnormality. Villous adenomas are a type of polyp that can cause localized mucosal secretion, leading to electrolyte and fluid imbalances.
**Why the Correct Answer is Right**
The metabolic abnormality commonly seen in large colorectal villous adenomas is hypokalemia. This occurs due to the secretion of potassium ions into the lumen by the tumor cells, leading to a decrease in serum potassium levels. The villous architecture of these tumors also increases the surface area for secretion, exacerbating the electrolyte imbalance. Additionally, the high turnover of cells in these tumors can lead to a high metabolic rate, further contributing to potassium loss.
**Why Each Wrong Option is Incorrect**
* **Option A:** This option is incorrect because while diarrhea can be a symptom of villous adenomas due to mucosal secretion, it is not the primary metabolic abnormality associated with these tumors.
* **Option B:** This option is incorrect because while hypocalcemia can occur in various gastrointestinal disorders, it is not specifically associated with villous adenomas.
* **Option C:** This option is incorrect because while hyperphosphatemia can occur in various metabolic disorders, it is not directly related to the pathophysiology of villous adenomas.
**Clinical Pearl / High-Yield Fact**
Large colorectal villous adenomas can cause significant electrolyte imbalances, particularly hypokalemia, due to the secretion of potassium ions into the lumen. This is an important consideration for clinicians when managing these patients, as prompt recognition and correction of electrolyte imbalances can help prevent complications.
**Correct Answer:** D. Hypokalemia