A 30-year-old primigravida complains of headaches, sweating, and tachycardia...

Question

A 30-year-old primigravida complains of headaches, restlessness, sweating, and tachycardia. She is 18 wk pregnant and her blood pressure is 200/120 mm Hg.
Appropriate workup might include

a. Exploratory laparotomy
b. Mesenteric angiography
c. Head CT scan
d. Abdominal CT scan
e. Abdominal ultrasonogram

Answer 1

e. Abdominal ultrasonogram

This patient presents with the symptoms of a pheochromocytoma. These tumors can initially become symptomatic during pregnancy. A noninvasive workup should be performed. Ultrasonography of the abdomen is frequently sufficient to localize the tumor to the right or left adrenal; an abdominal computed tomography (CT) scan with its large dose of radiation should be avoided in pregnancy.