10-07-2006, 07:52 AM
A 50-year-old man consults a physician because he has been having transient periods of rapid
heart beat accompanied by sweating, flushing, and a sense of impending doom. Physical
examination is unrevealing, with no evidence of arrhythmia at the time of the exam. However,
the man's wife is a nurse, so the physician asks that she take vital signs the next time one of
the episodes occurs. She does, and demonstrates a blood pressure of 195/140 mm Hg with
pulse of 160/min during the episode. She promptly takes her husband to the emergency room,
but the spell is over by the time that he is seen. Urinary measurement of which of the following
would most likely be diagnostic in this case?
A. Dehydroepiandrosterone
B. Human chorionic gonadotropin
C. 17-ketosteroids
D. Vanillylmandelic acid
E. Zinc protoporphyrin
heart beat accompanied by sweating, flushing, and a sense of impending doom. Physical
examination is unrevealing, with no evidence of arrhythmia at the time of the exam. However,
the man's wife is a nurse, so the physician asks that she take vital signs the next time one of
the episodes occurs. She does, and demonstrates a blood pressure of 195/140 mm Hg with
pulse of 160/min during the episode. She promptly takes her husband to the emergency room,
but the spell is over by the time that he is seen. Urinary measurement of which of the following
would most likely be diagnostic in this case?
A. Dehydroepiandrosterone
B. Human chorionic gonadotropin
C. 17-ketosteroids
D. Vanillylmandelic acid
E. Zinc protoporphyrin