Young female presents with hypeension with VMA >14 mg/day, associated with -a) Medullary Ca Thyroidb) Von Hippel Lindau diseasec) Sturge weber syndromed) Grave's diseasee) Neurofibromatosis

Biochemical tests for pheochromocytoma Most sensitive screening test : Urinary catecholamines and VMA levels Best diagnostic test : Fractionated plasma metanephrines Pharmacological tests Positive response to phentolamine is reduction of BP of atleast 35/25 mmHg after 2 min. It is not a diagnostic and biochemical confirmation Glucagon infusion increases catecholamines release and causes paroxysm of hypeension She is suspected of having pheochromocytoma Syndromes associated with pheochromocytoma (MVVS) MEN-2A & MEN-2B VHL syndrome Von-Recklinghausen syndrome Struge-weber syndrome Ref: schwaz's principle of surgery 10th edition Pgno :1586