<s>[INST] context: .Ampullary tumours mainly present with jaundice and weight loss.b. Carcinoma of head and neck region present with weight loss and jaundice. c. Cystadenocarcinoma of pancreas present with pain, weight loss . * Silvery stool (due to mixing of undigested fat with metabolised blood derived from the ooze of periampullary growth). * Loss of appetite and weight. * Scratch marks on the back. * Migratory superficial thrombophlebitis--Trousseau's sign (10%) is due to release of platelet aggregating factors from the tumour or its necrotic material. (Trousseau himself died of carcinoma pancreas who had migrating thrombophlebitis.) * Ascites. * Left supraclavicular palpable lymph node. * Secondaries in rectovesical pouch (Blumer's shelf). * Gall bladder may be palpable which is nontender, soft, globular, smooth, moving with respiration, mobile horizontally, dull on percussion. (30% in carcinoma head of pancreas; 50% in periampullary carcinoma). Courvoisier law ours gall bladder enlargement. * Liver is enlarged, smooth, firm, nontender, due to dilated bile filled biliary radicles--Hydrohepatosis. Liver can show multiple hard nodules due to secondaries. * Cystadenocarcinoma of pancreas can present with mass in epigastric region, which is nonmobile, not moving with respiration, smooth, soft, nontender. * Splenic vein thrombosis with splenomegaly (10%) can occur. ref:SRB&;S manual of surgery,ed 3,pg no 632 [/INST] question: Carcinoma of pancreas associated with | options: A: Hypoglycemia B: Syndrome of inappropriate secretion of ADH C: Erythropoisis is due to erythropoitin D: Hypercalcemia | answer: A </s>