A patient presents with intermittent headache. On examination there is hypeension and a thyroid nodule. Which of the following steps is to be taken next -
Urine HIAA levels
Urine VMA and aspiration of the thyroickiodule
Ultrasound abdomen
Echocardiography
Ans is option 2.. Urine VMA and aspiration of thyroid nodule. Intermittent headache (common symptom of pheochromocytoma) and thyroid nodule points towards Pheochromocytoma with medullary carcinoma thyroid Which inturn is a feature of MEN || syndrome Pheochromocytoma is diagnosed by demonstrating excretion of Catecholamines or its metabolites in urine Medullary Ca of thyroid is diagnosed by aspiration of thyroid nodule Ref Harrison 17/e p 2361
Endocrinology