APECED APS-1 — RACP Adult Medicine MCQ
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Correct answer: C — Measure plasma or urinary fractionated metanephrines before elective surgery
Explanation lettering: B = shown as A · C = shown as B · E = shown as C · A = shown as D · D = shown as E
E is correct. MEN2-associated phaeochromocytoma can be clinically silent and must be excluded biochemically before surgery. A falsely relies on symptoms and blood pressure. B imaging follows biochemical suspicion. C assesses medullary thyroid carcinoma. D unopposed beta blockade can precipitate crisis.
Reference: eviQ, RET (MEN2) risk management: https://www.eviq.org.au/cancer-genetics/adult/risk-management/1526-ret-men2-risk-management