NBME 2: 15-year-old girl is brought - khushigrover

[ArchivalUser]

grt to c u too
no step 3 left...
hope to take it next month..so back to the forum!
how abt u??

[ArchivalUser]

She is a 15 y/o Girl if she has Cushings the question would have told us that she also has ACNE, Hirsutism, Oligomenorrhea or Amenorrhea. On the other hand 10% of Pheo's are in children 10% are extraadrenal and 60% have stable hypertension. I think it would be wise to perform a cheap Urine Catecholamine test before treatment. B is my quess.

[ArchivalUser]

She is a 15 y/o Girl if she has Cushings the question would have told us that she also has ACNE, Hirsutism, Oligomenorrhea or Amenorrhea. On the other hand 10% of Pheo's are in children 10% are extraadrenal and 60% have stable hypertension. I think it would be wise to perform a cheap Urine Catecholamine test before treatment. B is my quess.

[ArchivalUser]

same here....however taking step 3 little later....probably in feb

[ArchivalUser]

She is a 15 y/o Girl if she has Cushings the question would have told us that she also has ACNE, Hirsutism, Oligomenorrhea or Amenorrhea. On the other hand 10% of Pheo's are in children 10% are extraadrenal and 60% have stable hypertension. I think it would be wise to perform a cheap Urine Catecholamine test before treatment. B is my quess.

[ArchivalUser]

She is a 15 y/o Girl if she has Cushings the question would have told us that she also has ACNE, Hirsutism, Oligomenorrhea or Amenorrhea. On the other hand 10% of Pheo's are in children 10% are extraadrenal and 60% have stable hypertension. I think it would be wise to perform a cheap Urine Catecholamine test before treatment. B is my quess.

[ArchivalUser]

Sorry didn't realize there where to pages

[ArchivalUser]

grt...hope to c ya around everyday

[ArchivalUser]

I guess ur thinking is right....however.....the only q is why not steroid...and why choose catechol first....both will be secondary causes....the recommendation is to do plasma as well as urine level of catechol and steroid.....u cant really choose between b and c...i guess only urine level of catechol and steroid is not appropriate and u have to do blood level as well....all pediatric hypertension...first step is life style modification and weight reduction with or without pharmacologic therapy...my first guess is A out of the above choices given....but its still open...if u can come with any convincing explanation

[ArchivalUser]

I don't think it is A because remember that they are testing for the best answer out of what is given. If you treat the PT this means you already ruled out secondary causes. However wether you choose B or C you are still looking for a cause and I think that is want to see.