A 50-Year-Old Man Comes to the Physician for Follow-Up of Epigastric

question 96

Multiple Choice

A 50-year-old man comes to the physician for follow-up of epigastric pain.  He was evaluated in the emergency department 3 days ago.  Abdominal CT scan with and without contrast showed a 2-cm left adrenal mass.  The lesion was homogenous with well-defined margins and low x-ray attenuation (2 Hounsfield units measured on noncontrast images) .  The abdominal pain resolved with antacids.  The patient has no other medical problems and takes no medications.  He denies weight gain, headache, flushing, sweating, muscle weakness, myalgias, or polyuria.  He smokes 5 cigarettes a day but does not drink alcohol or use illicit drugs.  Family history is unremarkable.
His blood pressure is 112/76 mm Hg and pulse is 67/min.  His BMI is 25 kg/m².  The physical examination is unremarkable.
Laboratory results are as follows:

What is the most appropriate next step in managing this patient?

• A)Evaluation for hormonal secretion
• B)Left adrenalectomy
• C)MRI of the abdomen
• D)No further work-up
• E)Repeat CT scan in 6 months

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Definitions:

Nursing Care Plan

A written guide created by nurses for the management of a patient's specific healthcare needs.

Impaired Verbal Communication

Difficulty in expressing thoughts and needs effectively through spoken language, which can be due to various reasons including physical, cognitive, or psychological barriers.

Motor Control

The ability of the nervous system to coordinate muscle movement and maintain balance.

Writing Board

A flat surface, often framed, on which one writes or attaches notices.