You have a patient with seizures, severely elevated blood pressure, and impaired mentation. You suspect the patient’s condition is an endocrine disorder. A 24-hour urine collection report shows an excess amount of catecholamine metabolites. What is the diagnosis?

Question

Group of answer choices

Multiple endocrine neoplasia.

Pineal tumor.

Pheochromocytoma.

Cushing’s syndrome.

Answer 1

Based on the patient's symptoms of seizures, severely elevated blood pressure, and impaired mentation, along with the 24-hour urine collection showing excess catecholamine metabolites, the most likely diagnosis is Pheochromocytoma.

Pheochromocytoma is a tumor of the adrenal gland that produces excess catecholamines (such as epinephrine and norepinephrine), leading to episodic hypertension, anxiety, headaches, palpitations, and other symptoms associated with catecholamine excess. The elevated blood pressure and neurologic symptoms align with this diagnosis.

Here's a brief summary of why the other options are less likely:

• Multiple endocrine neoplasia involves several endocrine glands but does not specifically correlate with high catecholamine metabolites.
• Pineal tumor generally affects melatonin production and is less commonly associated with catecholamine excess.
• Cushing’s syndrome is characterized by excess cortisol but not elevated catecholamines.

Thus, the correct diagnosis is Pheochromocytoma.