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  #1  
Old 08-28-2011
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Default phaeochromocytoma

Workup for an individual with paroxysmal hypertension reveals a pheochromocytoma. However, an abdominal/pelvic CT identified bilateral nephrolithiasis as well as an adrenal medulla mass. Further questioning reveals that the patient complains of muscle weakness and constipation. Your next step is to order a:
A. Renal ultrasound
B. Muscle biopsy
C. Cardiac echo
D. Thyroid ultrasound and fine needle biopsy
E. MRI of abdominal/pelvis
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  #2  
Old 08-28-2011
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Default D.

D. Thyroid ultrasound and fine needle biopsy, to rule out a medullary carcinoma of the thyroid / parathyroid tumor...MEN 2A syndrome
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Old 08-28-2011
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Answer is D
MEN B2
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  #4  
Old 08-28-2011
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going with d
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Old 08-28-2011
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sorry it's B1 MEN
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Old 08-29-2011
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MEN 2a..answer d

nephrolithiasis and constipation due to elevated calcium
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  #7  
Old 08-29-2011
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Default

Quote:
Originally Posted by ricko335 View Post
Workup for an individual with paroxysmal hypertension reveals a pheochromocytoma. However, an abdominal/pelvic CT identified bilateral nephrolithiasis as well as an adrenal medulla mass. Further questioning reveals that the patient complains of muscle weakness and constipation. Your next step is to order a:
A. Renal ultrasound
B. Muscle biopsy
C. Cardiac echo
D. Thyroid ultrasound and fine needle biopsy
E. MRI of abdominal/pelvis
C, cuz i think that too much nor epi and epi can cause too much vasoconstriction and it can cause ischemia to the heart
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  #8  
Old 08-29-2011
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Of cource this question is pointing to Men 2a.

Finding suggest

1. Pheochromocytoma
2. Nephrolithiasis = Parathyroid ca
and the last but not less which is the one asking on the question

CA Medullar...
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Old 08-30-2011
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The correct answer is D.
Pheochromocytomas are associated with MEN IIA and IIB syndromes. In this individual, nephrolithiasis with muscle weakness and constipation is suggestive of hypercalcemia. Hypercalcemia may be caused by a PTH adenoma. The next step is to order a thyroid ultrasound with fine needle biopsy to rule out medullary thyroid cancer as part of the MEN IIA syndrome.
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