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17602 Medicine

A 45 year old male presented with palpitations, tachycardia & anxiety. His BP is 158/90 mmHg. The patient also has mild depression and is presently taking citalopram, labetalol & amlodipine to control his blood pressure. 24-hour urine total metanephrines are ordered and show an elevation of 1.5 times the upper limit of normal. What is the next best step?

AHold labetalol for 1 week and repeat testing
BHold citalopram for 1 week and repeat testing
CRefer immediately for surgical evaluation
DMeasure 24-hour urine vanillylmandelic acid level
Medicine
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17603 Medicine

A 69-year-old man comes to the physician because of the gradual onset of pain, tingling and hyperesthesia in the medial aspect of his right arm. Shortly thereafter, he develops erythema and then an outbreak of vesicles on the medial aspect of his right arm extending from his medial epicondyle to the wrist. After several days. the lesions crust over and eventually resolve. However, he is left with a residual “burning” pain in the same distribution as the lesions with occasional episodes of sharp.1O/1O pain that is provoked by touch. He uses ice packs to suppress the pain at night but it has persisted despite this. The infectious agent responsible for this condition resides in which part of the neuraxis?

ABrainstem
BDorsal root ganglion
CSensory nerve axon
DSensory nerve root
Medicine
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