Last updated on:October 25th, 2020
You’re looking at an interactive scenario from Clinical Sense (one of four distinct learning formats available in Clinical Odyssey). Try it out, and have fun improving your clinical skills.
The endocrinology clinic can be quite challenging at times, but you've had a quiet day so far. The door opens once more, and your next patient comes in: 32-year-old Antonio, who has been referred by his primary care physician. You introduce yourself, shake hands, and ask him to take a seat.
You peruse the referral letter. This states that Antonio's blood pressure was found to be 140/90 mmHg at a routine health checkup. His blood pressure on the following day was 160/95 mmHg. Antonio was asymptomatic, with unremarkable medical and family histories. He was not on any medications and denied using recreational drugs. The examination was unremarkable.
A full blood count, serum sodium, potassium, and calcium levels, fasting plasma glucose, renal profile, liver profile, ECG and chest x-ray were normal. A thyroid profile, serum parathyroid hormone levels and an ultrasound scan of the neck were also normal.
However, abdominal ultrasound revealed a 3.5 × 5 cm mass above the right kidney. The primary care physician suspected this might be a pheochromocytoma, and referred Antonio to your clinic for further management.