Rosh Internal Medicine Boost Practice Exam

Which group of symptoms is consistent with pheochromocytoma in the context of adrenal tumors?

1. Weight gain and fatigue

2. Episodic sweating, headaches, and palpitations

3. Jaundice and ascites

4. Nausea and vomiting

The correct answer is: Episodic sweating, headaches, and palpitations

Pheochromocytoma is a tumor of the adrenal medulla that results in the overproduction of catecholamines, leading to a classic triad of symptoms: episodic sweating, headaches, and palpitations. This condition is characterized by paroxysmal episodes of these symptoms due to the release of excess adrenaline and noradrenaline into the bloodstream. Episodic sweating occurs as a result of the body's heightened sympathetic response, while headaches can be attributed to the increased blood pressure caused by catecholamine surges. Palpitations stem from the stimulatory effects of catecholamines on the heart, resulting in a rapid heartbeat. This combination of symptoms is distinctive for pheochromocytoma and serves as an important diagnostic clue for clinicians. The other symptom groups presented are associated with different medical conditions. Weight gain and fatigue are often seen in conditions such as hypothyroidism or Cushing's syndrome, jaundice and ascites relate to liver disease or conditions causing hepatic dysfunction, and nausea and vomiting might align with gastrointestinal disorders or other non-specific conditions. Hence, the combination of episodic sweating, headaches, and palpitations aligns specifically with the well-established clinical findings of pheochromocytoma.