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Patient with episodic pounding headaches and palpitations


Problem: A 42-year-old patient presents with episodic pounding headaches, palpitations, and diaphoresis. Episodes last 10-15 minutes and occur several times per week. During one episode in the clinic, the patient's blood pressure is 218/120 mm Hg, heart rate is 132 bpm, and skin is pale and clammy. Laboratory studies reveal elevated plasma metanephrines and normal cortisol levels. Which of the following best describes the pathophysiologic process underlying this patient's findings? Need Assignment Help?

Option A Defective feedback inhibition of renin secretion leading to sustained mineralocorticoid excess and hypertension Option B Adrenocorticotropic hormone (ACTH)-secreting pituitary adenoma causing secondary adrenal cortical hyperplasia Option C Autonomous secretion of catecholamines by a chromaffin cell tumor causing intermittent sympathetic hyperactivity Option D Excess glucocorticoid production from the adrenal cortex resulting in increased vascular sensitivity to catecholamines

 

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Other Subject: Patient with episodic pounding headaches and palpitations
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