nbmeanswersownersucksthe question hints at a possible parathyroid adenoma with her history of 2 episodes of renal calculi. +5
feochromocytomaYup, also as a tip for next time, if you see that a patient has some sort of pancreatic cell tumor, such as Zollinger in this case, look for other MEN 1 associated findings. +1
why isn't it serum cortisol concentration though. Couldn't that help you identify a pituitary adenoma (i.e. because increased ACTH --> increased cortisol concentration)?
rinais it because she's showing no symptoms or something? +
jj375I'm not sure but I would assume you would want to first confirm that her symptoms are from a gastrinoma (pancreatic endocrine tumor) and a parathyroid adenoma to confirm MEN1 before you would go and then try to preventatively check for a pituitary tumor even without symptoms. So I would guess it is just about what takes priority, focus on the things with the symptoms to confirmt he diagnosis+1
unknown001if the option included serum prolactin, then i would consider pituitary in the evaluation, because usmle is all about most common.
having said that, the next best is calcium assesment +
submitted by โmedninja(21)
MEN 1--> Pituitary tumors, pancreatic endocrine tumors (zollinger ellison or gastrinoma) and parathyroid adenomas.