Adrenal Disorders USMLE Step 1 Practice Question
A 52-year-old man presents with acute onset severe headache, profuse diaphoresis, palpitations, and blood pressure of 185/110 mmHg. His symptoms are episodic, lasting 30-60 minutes. Plasma metanephrines are elevated. An abdominal CT reveals a 3.2 cm right adrenal mass. Which of the following is the most appropriate next step in management?
Answer choices
- AInitiate alpha-blockade followed by beta-blockade, then surgical resectionCorrect answer
- BPerform adrenal biopsy for histologic confirmation
- CStart hydralazine and schedule a repeat CT in 3 months
- DImmediate surgical resection without pharmacologic preparation
- EBegin beta-blockade alone followed by surgery
- FNitroprusside for acute intraoperative catecholamine surges
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