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 -
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
Urine HIAA levels
Urine VMA and aspiration of the thyroickiodule
Ultrasound abdomen
Echocardiography
Endocrinology