A 38-year-old man with MEN 2A presents for preoperative evaluation before scheduled thyroidectomy for medullary thyroid carcinoma. Vital signs show BP 158/94 mmHg, HR 102 bpm, RR 16, temp 37°C. Recent imaging confirms thyroid nodule. Serum calcium is 10.2 mg/dL (normal). He denies headaches or diaphoresis. Which of the following endocrine abnormality should be excluded before surgery to reduce intraoperative hypertensive crisis risk?
- A)Acromegaly
- B)Prolactinoma
- C)Craniopharyngioma
- D)Primary hyperparathyroidism
- E)PheochromocytomaGABARITO
Explicação
In MEN 2A, pheochromocytoma must be identified and treated before thyroid surgery. Manipulation of an undiagnosed catecholamine secreting tumor can provoke life threatening hypertensive crisis during the operation. This sequencing point is emphasized in endocr... Ver explicação completa e trilha adaptativa →