]> 2026-07-31T07:52:21+00:00 WBR0229 0 en Refer him to psychiatrist '''Incorrect''' : Panic attacks can present in a similar way. However high blood pressure in one of the previous attack favors the diagnosis of pheochromocytoma. Measure the blood pressure in a week’s time '''Incorrect''' : Screening for pheochromocytoma should be the next step in the management of this patient. MRI of the abdomen '''Incorrect''' : MRI/CT is done only after biochemical confirmation is made for localizing the tumour. Measure 24-hour urine metanephrines and catecholamines '''Correct''' : Screening with plasma-free metanephrines (metanephrine and normetanephrine) or 24-hour urine metanephrines and catecholamines for confirming pheochromcytoma. Start anti-hypertensive’s '''Incorrect''' : Treatment is started after biochemical confirmation is made, because the drugs may interfere with interpretation of results. Emergency Room A 23 yr old male came to the emergency department with complaints of headache and palpitations. By time you attended the patient, he is asymptomatic. He reveals three similar episodes in the past that resolved spontaneously. He is currently on no medications and requests some pills to stop the episode because it is disturbing his preparation for exams. On examniation, you see a anxious and diaphorectic person in no acute distress. His temperature is 36.7 C, blood pressure is 130/70 mmHg, pulse is 102/min and respiartions are 16/min. Her oxygen saturation is 97% on room air. The neck is supple without any jugular venous distension or thyroid enlargement. The oropharynx is dry. Pupillary reflexes are intact. There is no obvious pallor or icterus. Lungs are clear to auscultation. Cardiovascular and gastrointestinal systems are unremarkable. During the prior visit in the ED for the similar episode his BP was 158/90mmHg. What is the most appropriate next step in the patient management? D Endocrine 2020-10-27T23:49:57Z 2459150.4930208 WBR0229