A 25-year-old woman is admitted for a hypertensive crisis, her blood pressure is labile and responds poorly to antihypertensive therapy. The patient complains of headache, palpitations, and diaphoresis Which of the following is the most appropriate next step in diagnosis?
سؤال مجاني 7 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: D. Urinary assay for free catecholamines and vanillylmandelic acid
Labile, treatment-resistant hypertension with headache, palpitations and sweating suggests pheochromocytoma; diagnosis is biochemical with 24-hour urine catecholamines and their metabolites (metanephrines/VMA). Option B measures plasma epinephrine/norepinephrine themselves, which the sources do not recommend (they recommend plasma metanephrines). Pituitary MRI and fasting glucose are not diagnostic.
ليش كل خيار صح أو غلط
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A
ليش غلط
Imaging for pheochromocytoma is a CT or MRI of the abdomen and pelvis to localize the tumour, not a pituitary MRI.
✓ Step Up To Medicine 6th Edition 2024 (Adrenal).pdf · p. 6 -
B
ليش غلط
The recommended blood test is plasma metanephrines (breakdown products of catecholamines), not the epinephrine and norepinephrine themselves.
✓ Step Up To Medicine 6th Edition 2024 (Adrenal).pdf · p. 6 -
C
ليش غلط
Hyperglycemia is only a supporting laboratory finding of pheochromocytoma; the diagnosis rests on testing catecholamine breakdown products.
✓ Step Up To Medicine 6th Edition 2024 (Adrenal).pdf · p. 6 -
D
ليش صح
Diagnosis is biochemical: a urine screen for catecholamine breakdown products, with a 24-hour urine collection of metanephrines and catecholamines, comes first.
✓ Step Up To Medicine 6th Edition 2024 (Adrenal).pdf · p. 6
- المصدر
- RT - Adrenal.pdf · p. 21
Step Up To Medicine 6th Edition 2024 (Adrenal).pdf · p. 6 - المحاضرة
- Pheochromocytoma · Endocrinology · Module B
- ظهر في
- Endo bank