Phaeochromocytoma Screening — RACP Adult Medicine MCQ

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EasyEndocrinologyPhaeochromocytoma ScreeningRACP Adult Medicine

A 40-year-old man with paroxysmal hypertension (episodes of headache, sweating, palpitations with BP 230/130 mmHg) has a family history of phaeochromocytoma. Which screening test is most appropriate?

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Correct answer: B — Plasma metanephrines

Paroxysmal hypertension with the classic triad (headache, sweating, palpitations) and family history warrants screening for phaeochromocytoma. Plasma free metanephrines (fractionated: metanephrine and normetanephrine) are the most sensitive screening test (>96% sensitivity). 24-hour urine fractionated metanephrines and catecholamines are an alternative. Blood should be drawn supine after 30 minutes rest.

Reference: Endocrine Society – 2014 – Phaeochromocytoma; ESA 2024