2240.亚急性甲状腺炎,下列治疗方法哪项最有效?(易、记忆) A.消炎痛 B.强的松 C.心得安 D.碘剂治疗 E.甲状腺片 2241慢性淋巴性甲状腺炎典型的体征是(易、记忆) A.甲状腺结节扫描为冷结节 B.甲状腺结节扫描为温结节 C.甲状腺肿大伴触痛 D.甲状腺肿大、质硬、表面不光滑 E.结节性甲状腺肿 2242诊断桥本甲状腺炎有价值的是(易、记忆) A.TGA、TPO升高 B.TRAb升高 C.甲状腺肿大伴触痛 D.h-TG升高 E.结节性甲状腺肿 2243对诊断功能亢进性甲状腺腺瘤有意义的是(易、记忆) A.甲状腺结节扫描为冷结节 B.甲状腺结节扫描为热结节 C.甲状腺肿大伴触痛 D.甲状腺肿大、质硬 E.结节性甲状腺肿 224女性,49岁。洗澡时无意中发现颈前部结节就诊。体检:甲状腺右叶可触及一结节3cm ×5cm,质韧,无压痛,血管杂音(一),对侧甲状腺未及肿大。心率72次/min,律齐。为 进一步明确诊断,应首先选择哪项检查?(中、应用) A.T3、T4 B.甲状腺吸碘率测定 C.甲状腺扫描 D.基础代谢率测定 E.甲状腺球蛋白抗体(TGA) 2245血清降钙素升高,是哪种疾病的较特异性标志(易,记忆) A.甲状腺脓肿 B.甲状腺髓样癌 C.甲状腺囊肿 D.自主性高功能腺瘤 E.甲状腺滤泡癌 *2246. A 45-year-old woman is referred to you after a thyroid nodule was found on routine physical exam. The patient was not aware that she had a mass in her thyroid and has no history of any previous thyroid disease or thyroid nodule. There is no family history of thyroid disease or thyroid nodules. The patient has no history of radiation therapy of any type to the head or neck The patient has no symptoms of hyper- or hypothyroidism. Lab tests reveal a TSH level of 1.5 mlU per milliliter( normal: 0.32 to 5), and the patient undergoes a fine-needle aspiration biopsy of this nodule. The pathology report reveals a hyper cellular lesion with no colloid, consistent with a follicular lesion. Your next step in the evaluation of this patients thyroid nodule, based on the
2240.亚急性甲状腺炎，下列治疗方法哪项最有效？（易、记忆） A．消炎痛 B．强的松 C．心得安 D．碘剂治疗 E．甲状腺片 2241.慢性淋巴性甲状腺炎典型的体征是（易、记忆） A．甲状腺结节扫描为冷结节 B．甲状腺结节扫描为温结节 C．甲状腺肿大伴触痛 D．甲状腺肿大、质硬、表面不光滑 E．结节性甲状腺肿 2242.诊断桥本甲状腺炎有价值的是（易、记忆） A．TGA、TPO 升高 B．TRAb 升高 C．甲状腺肿大伴触痛 D．h-TG 升高 E．结节性甲状腺肿 2243.对诊断功能亢进性甲状腺腺瘤有意义的是（易、记忆） A．甲状腺结节扫描为冷结节 B．甲状腺结节扫描为热结节 C．甲状腺肿大伴触痛 D．甲状腺肿大、质硬 E．结节性甲状腺肿 2244.女性，49 岁。洗澡时无意中发现颈前部结节就诊。体检：甲状腺右叶可触及一结节 3cm ×5cm，质韧，无压痛，血管杂音（－），对侧甲状腺未及肿大。心率 72 次/min，律齐。为 进一步明确诊断，应首先选择哪项检查？（中、应用） A．T3、T4 B．甲状腺吸碘率测定 C．甲状腺扫描 D．基础代谢率测定 E．甲状腺球蛋白抗体（TGA） 2245.血清降钙素升高，是哪种疾病的较特异性标志（易，记忆） A．甲状腺脓肿 B．甲状腺髓样癌 C．甲状腺囊肿 D．自主性高功能腺瘤 E．甲状腺滤泡癌 *2246. A 45-year-old woman is referred to you after a thyroid nodule was found on routine physical exam. The patient was not aware that she had a mass in her thyroid and has no history of any previous thyroid disease or thyroid nodule. There is no family history of thyroid disease or thyroid nodules. The patient has no history of radiation therapy of any type to the head or neck. The patient has no symptoms of hyper- or hypothyroidism. Lab tests reveal a TSH level of 1.5 mIU per milliliter(normal: 0.32 to 5), and the patient undergoes a fine-needle aspiration biopsy of this nodule. The pathology report reveals a hyper cellular lesion with no colloid, consistent with a ‘follicular lesion’. Your next step in the evaluation of this patient’s thyroid nodule, based on the
aboratory and cytopathologic findings noted above,is(难、应用) A. Refer the patient to a surgeon specializing in thyroid surgery for thyroidectomy B. Initiate levothyroxine therapy to suppress the nodule C. Recommend follow-up with ultrasound in 6 months to see if the nodule is increasing in size D. Do a thyroid scan to determine if the nodule ishot'versuscold' orwarm E. Advise the patient to have rebiopsy in 2 months 2247. Which of the following thyroid cancers are responsive to3 I therapy?(易、应用) A. Follicular cancer of the thyroid B. Medullary cancer of the thyroid C. Anaplastic thyroid D. Primary lymphoma of the thyroid E. Both a and c *2248. A 30-year-old man is evaluated for a thyroid nodule. The patient reports that his father died from thyroid cancer'and that a brother had a history of recurrent renal stones. Blood calcitonin concentration is 2000pg/mL(normal: less than 100); serum calcium and phosphate levels are normal. Before referring the patient to a surgeon, the physician should(难、应用) A. obtain a liver scan B. perform a calcium infusion test C. measure urinary catecholamines D. administer suppressive doses of thyroxine and measure levels of thyroid stimulating hormone E. treat the patient with radioactive iodine 2249. An otherwise healthy 60-year-old man is noted on routine examination to have a firm thyroid nodule. Serum thyroxine is 8.0 W g/dL(normal: 4 to 11). Thyroid scan demonstrates cold'nodule. The appropriate management would be which of the following procedures? (53 应用 A. Complete lobectomy B. Fine needle aspiration cytology C. Levothyroxine D. Radioactive iodin therapy E. External irradiation 2250. A 60-year-old woman presents with generalized muscle weakness, loss If appetit palpitations, and a small diffuse nodular goiter. An electrocardiogram reveals rapid atrial fibrillation Despite adequate digitalization there is little slowing of her ventricular rate. Thyroid function studies reveal a serum thyroxine level of 12 u g/dl(normal: 5 to 12),with a triiodothyronine(T3)level of 200ng/dL(normal: 80 to 160), as measured by radioimmunoassay and a highly sensitive thyroid-stimulating hormone(TSH) of 0.05 H lU/mL(normal: 0.3 to 3.0) The most likely diagnosis and appropriate treatment would be(易、应用) A. typical Graves'disease; therapy with antithyroid drugs B. mild Graves'disease; initiation of therapy with low dose of 3I C. tocic multinodular goiter; therapy with antithyroid drugs followed by surgery D. toxic multinodular goiter; therapy with antithyroid drugs followed by high dose of 3I when euthyroid E. sick euthyroid syndrome; continuation of treatment of heart disease with digoxin and 2251.ACIH依赖性皮质醇增多症最常见的病因是(易,记忆) A垂体ACTH细胞增生
laboratory and cytopathologic findings noted above, is （难、应用） A. Refer the patient to a surgeon specializing in thyroid surgery for thyroidectomy B. Initiate levothyroxine therapy to suppress the nodule C. Recommend follow-up with ultrasound in 6 months to see if the nodule is increasing in size D. Do a thyroid scan to determine if the nodule is ‘hot’ versus ‘cold’ or ‘warm’ E. Advise the patient to have rebiopsy in 2 months. 2247. Which of the following thyroid cancers are responsive to 131I therapy?（易、应用） A. Follicular cancer of the thyroid B. Medullary cancer of the thyroid C. Anaplastic thyroid cancer D. Primary lymphoma of the thyroid E. Both A and C *2248. A 30-year-old man is evaluated for a thyroid nodule. The patient reports that his father died from ‘thyroid cancer’ and that a brother had a historhy of recurrent renal stones. Blood calcitonin concentration is 2000pg/mL(normal: less than 100) ; serum calcium and phosphate levels are normal. Before referring the patient to a surgeon, the physician should （难、应用） A. obtain a liver scan B. perform a calcium infusion test C. measure urinary catecholamines D. administer suppressive doses of thyroxine and measure levels of thyroid stimulating hormone E. treat the patient with radioactive iodine 2249. An otherwise healthy 60-year-old man is noted on routine examination to have a firm thyroid nodule. Serum thyroxine is 8.0 μg/dL(normal: 4 to 11). Thyroid scan demonstrates a ‘cold ‘nodule. The appropriate management would be which of the following procedures? （易、 应用） A. Complete lobectomy B. Fine needle aspiration cytology C. Levothyroxine D. Radioactive iodinw therapy E. External irradiation 2250. A 60-year-old woman presents with generalized muscle weakness, loss lf appetite, palpitations, and a small diffuse nodular goiter. An electrocardiogram reveals rapid atrial fibrillation. Despite adequate digitalization there is little slowing of her ventricular rate. Thyroid function studies reveal a serum thyroxine level of 12 μg/dL(normal: 5 to 12), with a triiodothyronine(T3) level of 200ng/dL(normal: 80 to 160), as measured by radioimmunoassay and a highly sensitive thyroid-stimulating hormone(TSH) of 0.05μIU/mL(normal: 0.3 to 3.0) The most likely diagnosis and appropriate treatment would be（易、应用） A. typical Graves’ disease; therapy with antithyroid drugs B. mild Graves’ disease; initiation of therapy with low dose of 131I C. tocic multinodular goiter; therapy with antithyroid drugs followed by surgery D. toxic multinodular goiter;therapy with antithyroid drugs followed by high dose of 131I when euthyroid E. sick euthyroid syndrome; continuation of treatment of heart disease with digoxin and propranolol 2251. ACTH 依赖性皮质醇增多症最常见的病因是（易，记忆） A 垂体 ACTH 细胞增生
B垂体ACTH瘤 C异位ACTH分泌综合征 D肾上腺腺瘤 E大结节性巨大肾上腺瘤 2252.非ACTH依赖性皮质醇增多症常见的病因是(易,记忆) A肾上腺皮质腺瘤 B原发性色素结节性肾上腺病 C异位ACIH分泌综合征 D假性 Cushing综合征 E大结节性巨大肾上腺瘤 2253.小剂量地塞米松抑制试验可用于(中,理解) A皮质醇增多症的定位诊断 B醛固酮增多症的定位诊断 C单纯性肥胖与皮质醇增多症的鉴别诊断 D嗜铬细胞瘤的鉴别诊断 E肾上腺皮质功能的评价 2254.大剂量地塞米松抑制试验可用于提示(中,理解) A嗜铬细胞瘤的鉴别诊断 B醛固酮增多症的鉴别诊断 C皮质醇增多症的定位和病因 D肾上腺皮质功能状态 E垂体瘤的功能评价 2255.女性,30岁,因肥胖,乏力2年就诊,下列哪一项体征是帮助诊断皮质醇增多症的重 要线索(易,应用) A肥胖 B满月脸 C高血压 D皮肤痤疮 E皮肤宽大紫纹 2256. The most common cause of primary hyperaldosteronism is:(中,记忆) A. aldosterone-producing adenoma B diopathic hyperaldosterone C. primary adrenal hyperplas D. adrenal cortical adenocarcinoma E. glucocorticoid-supperessible hyperaldosterone 2257. The characteristic manifestations of primary aldosteronism is: (H, #A) ABC hypopotassemia D. hypertension, hypopotassemia, hyperaldosterone, lower renin activity E. lower activity of renin *258.对于原发性醛固酮增多症患者治疗方案选择正确的是:(难,理解) A.分泌醛固酮的肾上腺皮质腺瘤(APA)首选手术治疗 B.手术治疗分泌醛固酮的肾上腺皮质腺瘤(APA)术前不应该口服螺内酯 C.原发性肾上腺增生(PAH)不能进行手术治疗 D.肾上腺特发性增生(IHA)经螺内酯控制血压后,都要行手术治疗
B 垂体 ACTH 瘤 C 异位 ACTH 分泌综合征 D 肾上腺腺瘤 E 大结节性巨大肾上腺瘤 2252. 非 ACTH 依赖性皮质醇增多症常见的病因是（易，记忆） A 肾上腺皮质腺瘤 B 原发性色素结节性肾上腺病 C 异位 ACTH 分泌综合征 D 假性 Cushing 综合征 E 大结节性巨大肾上腺瘤 2253. 小剂量地塞米松抑制试验可用于（中，理解） A 皮质醇增多症的定位诊断 B 醛固酮增多症的定位诊断 C 单纯性肥胖与皮质醇增多症的鉴别诊断 D 嗜铬细胞瘤的鉴别诊断 E 肾上腺皮质功能的评价 2254. 大剂量地塞米松抑制试验可用于提示（中，理解） A 嗜铬细胞瘤的鉴别诊断 B 醛固酮增多症的鉴别诊断 C 皮质醇增多症的定位和病因 D 肾上腺皮质功能状态 E 垂体瘤的功能评价 2255. 女性，30 岁，因肥胖，乏力 2 年就诊，下列哪一项体征是帮助诊断皮质醇增多症的重 要线索（易，应用） A 肥胖 B 满月脸 C 高血压 D 皮肤痤疮 E 皮肤宽大紫纹 2256. The most common cause of primary hyperaldosteronism is:（中，记忆） A． aldosterone-producing adenoma B． idiopathic hyperaldosterone C． primary adrenal hyperplasia D． adrenal cortical adenocarcinoma E． glucocorticoid-supperessible hyperaldosterone 2257. The characteristic manifestations of primary aldosteronism is:（中，理解） A． hypertension B． hypopotassemia C． hyperpotassemia D． hypertension、hypopotassemia、hyperaldosterone、lower renin activity E． lower activity of renin *2258. 对于原发性醛固酮增多症患者治疗方案选择正确的是：（难，理解） A． 分泌醛固酮的肾上腺皮质腺瘤（APA）首选手术治疗 B． 手术治疗分泌醛固酮的肾上腺皮质腺瘤（APA）术前不应该口服螺内酯 C． 原发性肾上腺增生（PAH）不能进行手术治疗 D． 肾上腺特发性增生（IHA）经螺内酯控制血压后，都要行手术治疗
E.螺内酯只能用于不能手术的原发性醛固酮增多症患者 2259原发性肾上腺皮质功能减退最主要的病因是(易,记忆) 特发性(包括自身免疫性和多发内分泌腺功能减退症) ABCD 肾上腺结核 肾上腺转移癌 脑垂体功能减退 E 先天性ACTH反应障碍 2260.下列哪一项检査对鉴别原发和继发性肾上腺皮质功能减退具有重要意义(中,理解) A血浆皮质醇节律 B24小时尿17一羟,17一酮测定 C24小时尿游离皮质醇测定 D基础ACIH测定 E肾上腺CT *2261先天性肾上腺皮质增生症( congenital adrenal hyperplasia,CAH)是由于肾上腺皮质激素 生物合成酶系中某一或数种酶的先天性缺陷使皮质醇等激素水平改变所致的一组疾病。按缺 陷酶的种类,可分五类,以下哪几种组合是正确的?(中,记忆) A.2l-羟化酶缺陷症,11-β-羟化酶缺陷症,3β-羟类固醇脱氢酶缺陷症,1α-羟化酶缺陷症, 胆固醇碳链酶缺陷症 B.21-羟化酶缺陷症失盐型,男性化型,不典型亚型,17α-羟化酶缺陷症,1l-β-羟化酶缺陷 症, C.21-羟化酶缺陷症失盐型,男性化型,17α-羟化酶缺陷症l-β-羟化酶缺陷症,胆固醇碳 链酶缺陷症 D.21-羟化酶缺陷症失盐型,单纯男性化型,非典型失盐型,皮质醇缺乏型,11-β-羟化酶缺 陷症 E.2l-羟化酶缺陷症,ll-β-羟化酶缺陷症,3β-羟类固醇脱氢酶缺陷症,1β-羟化酶缺陷症,胆 固醇碳链酶缺陷症 *2262.21-羟化酶缺陷症的典型特征是:(难、应用) A.有明显的男性化或女性假两性畸形、高钾血症、低钠血症,高睾酮血症,高血浆ACTH 低肾素活性,高17-a羟孕酮 B.有明显的男性化或女性假两性畸形、高钾血症、低钠血症,高睾酮血症,高血浆ACTH 低血浆皮质醇,高17-a羟孕酮 C.有明显的男性化或女性假两性畸形、低钾血症、高钠血症,高睾酮血症,高血浆ACTH 高肾素活性,高17-羟孕酮 D.有明显的男性化或女性假两性畸形、高钾血症、低钠血症,低睾酮血症,高血浆ACTH 高肾素活性,高醛固酮血症。 E.有明显的男性化或女性假两性畸形、高钾血症、低钠血症,低睾酮血症,高血浆ACTH 高肾素活性,低醛固酮血症。 2263挑选出下列项目中符合嗜铬细胞瘤者:(中、理解) A.收缩压与舒张压均升高,高血压可呈间歇性或持续性发作 B.所谓 Sipple综合征是本症与慢性甲状腺炎的合并, C.尿中肾上腺素,去甲肾上腺素增多,但MA量不增多。 D.酚妥拉明( regitine)试验,可用于阵发性者,为激发试验 E.90%的嗜铬细胞瘤位于肾上腺皮质内。 *2264患者于切除嗜铬细胞瘤后即刻发生低血压,应立即采用下列哪种治疗?(难、应用) A.皮质类固醇 B.盐皮质激素
E． 螺内酯只能用于不能手术的原发性醛固酮增多症患者 2259.原发性肾上腺皮质功能减退最主要的病因是（易，记忆） A 特发性（包括自身免疫性和多发内分泌腺功能减退症） B 肾上腺结核 C 肾上腺转移癌 D 脑垂体功能减退 E 先天性 ACTH 反应障碍 2260.下列哪一项检查对鉴别原发和继发性肾上腺皮质功能减退具有重要意义（中，理解） A 血浆皮质醇节律 B 24 小时尿 17－羟，17－酮测定 C 24 小时尿游离皮质醇测定 D 基础 ACTH 测定 E 肾上腺 CT *2261.先天性肾上腺皮质增生症(congenital adrenal hyperplasia, CAH)是由于肾上腺皮质激素 生物合成酶系中某一或数种酶的先天性缺陷使皮质醇等激素水平改变所致的一组疾病。按缺 陷酶的种类，可分五类,以下哪几种组合是正确的？（中，记忆） A. 21-羟化酶缺陷症, 11-β-羟化酶缺陷症, 3β-羟类固醇脱氢酶缺陷症, 17α-羟化酶缺陷症, 胆固醇碳链酶缺陷症 B. 21-羟化酶缺陷症失盐型, 男性化型, 不典型亚型, 17α-羟化酶缺陷症, 11-β-羟化酶缺陷 症, C. 21-羟化酶缺陷症失盐型, 男性化型, 17α-羟化酶缺陷症, 11-β-羟化酶缺陷症, 胆固醇碳 链酶缺陷症 D. 21-羟化酶缺陷症失盐型, 单纯男性化型, 非典型失盐型, 皮质醇缺乏型，11-β-羟化酶缺 陷症, E. 21-羟化酶缺陷症, 11-β-羟化酶缺陷症, 3β-羟类固醇脱氢酶缺陷症, 17-羟化酶缺陷症,胆 固醇碳链酶缺陷症 *2262. 21-羟化酶缺陷症的典型特征是：(难、应用) A. 有明显的男性化或女性假两性畸形、高钾血症、低钠血症，高睾酮血症，高血浆 ACTH、 低肾素活性，高 17-羟孕酮 B. 有明显的男性化或女性假两性畸形、高钾血症、低钠血症，高睾酮血症，高血浆 ACTH、 低血浆皮质醇，高 17-羟孕酮 C. 有明显的男性化或女性假两性畸形、低钾血症、高钠血症，高睾酮血症，高血浆 ACTH、 高肾素活性，高 17-羟孕酮 D. 有明显的男性化或女性假两性畸形、高钾血症、低钠血症，低睾酮血症，高血浆 ACTH、 高肾素活性，高醛固酮血症。 E. 有明显的男性化或女性假两性畸形、高钾血症、低钠血症，低睾酮血症，高血浆 ACTH、 高肾素活性，低醛固酮血症。 2263.挑选出下列项目中符合嗜铬细胞瘤者：(中、理解) A．收缩压与舒张压均升高，高血压可呈间歇性或持续性发作． B．所谓 Sipple 综合征是本症与慢性甲状腺炎的合并。 C．尿中肾上腺素，去甲肾上腺素增多，但 VMA 量不增多。 D．酚妥拉明（regitine）试验，可用于阵发性者，为激发试验。 E．90%的嗜铬细胞瘤位于肾上腺皮质内。 *2264.患者于切除嗜铬细胞瘤后即刻发生低血压，应立即采用下列哪种治疗？(难、应用) A.皮质类固醇 B.盐皮质激素
C.α-肾上腺素能受体兴奋剂 Dβ肾上腺素能受体兴奋剂 E输血或输血浆 265诊断嗜铬细胞瘤最好的初筛试验是:(中、理解) A.酚妥拉明试验 B.组胺试验 C测定24小时尿中ⅥMA D肾动脉造影 E测定血中儿茶酚胺 2266. A 42-year-old white man comes in with a 5-month history of episodes associated with headaches, palpitations along with chest pain, and blurring of his vision He had seen his family physician on several occasions with no abnormality noted on physical exam. However, he had one on the episodes when leaving his family physician's office on his last visit, and the nurse, who checked his blood pressure of 190/110mmHg, with his usual blood pressure being 130/70 mmh His family physician referred him to you and told the patient that he had a 'glandular disorder The patient's phy sical examination is unremarkable, with a blood pressure of 126/85mmHg Because he has been having one or two episodes a week, ambulatory blood pressure monitoring is done, revealing his blood pressure rising from approximately 140/80 to 220/130 mmHg before returning to normal after the episode resolves. Six days after his last paroxysm, the patient has serum catecholamines properly collected, revealing a serum norepinephrine level of 200pg per milliliter and an epinephrine level of 30pg per milliliter(normal: norepinephrine 220pg per milliliter and an epinephrine 35). Your best interpretation of the above test results in the context of this patient' symptoms and objective findings is(易、应用) A. The above biochemical data exclude a pheochromyuocytoma B. The above biochemical data do not exclude pheochromocytoma because some patients with pheochromocytoma may have normal plasma catecholamine levels when they are asymptomatic and normotensive C. A 24-hour urine measure of vanillylmandelic acid(VMA), metanephrine, and catecholamine levels that is normal during an asymptomatic phase would absolutely exclude pheochromocytoma. D. None of the above E. All of the above 2267. A 34-year-old white man gives a l-year history of sudden onset of episodes of headache followed by palpitations and diaphoresis and a feeling of doom. These episodes initially were occurring about once every 2 weeks but now are occurring once every 3 to 4 days. They typically last 30 to 45 minutes. Recently, during an episode that led him to go to the emergency room, it was noted that his blood pressure was 190/130mmHg. He was given diazepam and, after the episode was over, his blood pressure was 140/96mmHg In your office, exam reveals a blood pressure of 144/98mmHg without orthostatic drop and a pulse of 90 beats per minute(regular) Physical exam otherwise is unremarkable except for a 3-cm nodule in the left lobe of the thyroid of which the patient was not aware. Which of the following statements is/are true with regard to this patient' s history and clinical findings?(易、应用) A 24-hr urine for VMA, metanephrines, and catecholamines would be expected to be elevated in this patient, if done after a spell as described above B Family history of endocrine-related disorders, including pheochromocytoma, thyroid cancer, and/or hyperparathroidism, would be expected
C.α-肾上腺素能受体兴奋剂 D.β-肾上腺素能受体兴奋剂 E.输血或输血浆 2265.诊断嗜铬细胞瘤最好的初筛试验是：(中、理解) A.酚妥拉明试验 B.组胺试验 C.测定 24 小时尿中 VMA D.肾动脉造影 E.测定血中儿茶酚胺 2266. A 42-year-old white man comes in with a 5-month history of episodes associated with headaches, palpitations along with chest pain, and blurring of his vision. He had seen his family physician on several occasions with no abnormality noted on physical exam. However, he had one on the episodes when leaving his family physician’s office on his last visit, and the nurse, who checked his blood pressure of 190/110mmHg, with his usual blood pressure being 130/70 mmHg. His family physician referred him to you and told the patient that he had a ‘glandular disorder.’ The patient’s physical examination is unremarkable, with a blood pressure of 126/85mmHg. Because he has been having one or two episodes a week, ambulatory blood pressure monitoring is done, revealing his blood pressure rising from approximately 140/80 to 220/130 mmHg before returning to normal after the episode resolves. Six days after his last paroxysm, the patient has serum catecholamines properly collected, revealing a serum norepinephrine level of 200pg per milliliter and an epinephrine level of 30pg per milliliter(normal: norepinephrine < 220pg per milliliter and an epinephrine < 35). Your best interpretation of the above test results in the context of this patient’s symptoms and objective findings is（易、应用） A. The above biochemical data exclude a pheochromyuocytoma B. The above biochemical data do not exclude pheochromocytoma because some patients with pheochromocytoma may have normal plasma catecholamine levels when they are asymptomatic and normotensive. C. A 24-hour urine measure of vanillylmandelic acid(VMA), metanephrine, and catecholamine levels that is normal during an asymptomatic phase would absolutely exclude pheochromocytoma. D. None of the above E. All of the above 2267. A 34-year-old white man gives a 1-year history of sudden onset of episodes of headache followed by palpitations and diaphoresis and a feeling of doom. These episodes initially were occurring about once every 2 weeks but now are occurring once every 3 to 4 days. They typically last 30 to 45 minutes. Recently, during an episode that led him to go to the emergency room, it was noted that his blood pressure was 190/130mmHg. He was given diazepam and, after the episode was over, his blood pressure was 140/96mmHg. In your office, exam reveals a blood pressure of 144/98mmHg without orthostatic drop and a pulse of 90 beats per minute (regular). Physical exam otherwise is unremarkable except for a 3-cm nodule in the left lobe of the thyroid, of which the patient was not aware. Which of the following statements is/are true with regard to this patient’s history and clinical findings? （易、应用） A 24-hr urine for VMA, metanephrines, and catecholamines would be expected to be elevated in this patient, if done after a spell as described above. B.Family history of endocrine-related disorders, including pheochromocytoma, thyroid cancer, and/or hyperparathroidism, would be expected