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181335 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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