A 26-year-old man is brought to the emergency department after being found by his family on his bathroom floor. He had apparently collapsed after being increasingly ill. His mother reports that over the last several weeks he has had severe insomnia, tremors, diarrhea, and fatigue. On arrival is only vaguely interactive and he does not follow commands appropriately. His blood pressure is 143/89, pulse is 125/min and his oxygen saturation is 96% on room air. On examination, he is diaphoretic and has a wide-eyed stare. He has a 2/6-midsystolic murmur at the second left intercostal space. His deep tendon reflexes are brisk throughout. Laboratory studies show:
Which of the following is the most appropriate next test to establish the etiology of this patient's collapse?
A.
24-hour urine for total catecholamines
B.
CT scan of the head
C.
Radioactive iodine uptake scan of the thyroid
D.
Serum thyrotropin-releasing hormone (TRH)
E.
Serum free triiodothyronine (T3) level
Which of the following is the most appropriate next test to establish the etiology of this patient's collapse?
A.
24-hour urine for total catecholamines
B.
CT scan of the head
C.
Radioactive iodine uptake scan of the thyroid
D.
Serum thyrotropin-releasing hormone (TRH)
E.
Serum free triiodothyronine (T3) level