A 50-year-old man consults a physician

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 heart rate 160/min during the episode. She promptly takes her husband to theemergency 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 (DHEA)
B. Human chorionic gonadotropin (hCG)
C. 17-ketosteroids
D. Vanillylmandelic acid (VMA)
E. Zinc protoporphyrin

Ans:

D. Vanillylmandelic acid (VMA)