Step 1

Biochemistry 13

A 35-year-old woman presents to the urgent care clinic for evaluation of headache and episodes of heart palpitations which began 4 months ago. These symptoms are accompanied by sweating. Her medical history is significant for a copper intrauterine device (IUD) implanted 2 years ago. She does not smoke cigarettes and drinks 6-7 glasses of wine per month. Her blood pressure in the clinic is 190/135 mmHg, pulse is 117 beats/minute. Physical examination is significant for tachycardia, generalized skin pallor, and no abdominal bruits.

Which of the following plasma values is most likely elevated in this patient?

  • A) Direct (unconjugated) bilirubin
  • B) Homocysteine
  • C) Homovanillic acid
  • D) Orexin
  • E) 14-3-3 protein


Alexandra Conway


Dr. Ted O'Connell