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Medicine General 61cc3d4a

A patient presents with an intermittent headache. On examination, there is hypertension and a thyroid nodule. Which of the following steps is to be taken next -

A
Urine HIAA levels
B
Urine VMA and aspiration of the thyroid nodule
C
Ultrasound abdomen
D
Echocardiography
High-Yield Explanation
Intermittent headache (which is the most common symptom of Phaeochromocytoma) and thyroid Nodule points towards the occurrence of Phaeochromocytoma with Medullary Carcinoma Thyroid. Pheochromocytoma together with medullary carcinoma of thyroid is a feature of MEN II syndrome. They are associated with both MEN IIA and MEN IIB.   Diagnosis of phaeochromocytoma It is done by demonstrating excretion of catecholamine or catecholamine metobolites in urine. The assays employed include those for Vanillymandelic acid Metanephrines Unconjugated catecholamines or free Catecholamines. For the diagnosis of Medullary Ca Thyroid aspiration is done of Thyroid Nodule.

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