<prompt> A patient presents with an intermittent headache. On examination, there is hypertension and a thyroid nodule. Which of the following steps is to be taken next -Urine HIAA levelsUrine VMA and aspiration of the thyroid noduleUltrasound abdomenEchocardiography  <response>: Intermittent headache which is the most common symptom of Phaeochromocytoma and thyroid Nodule points towards the occurrence of Phaeochromocytoma with Medullary Carcinoma Thyroid.Pheochromocytoma together with medullary carcinoma of thyroid is a feature of MEN II syndrome.They are associated with both MEN IIA and MEN IIB. Diagnosis of phaeochromocytoma It is done by demonstrating excretion of catecholamine or catecholamine metobolites in urine.The assays employed include those forVanillymandelic acidMetanephrinesUnconjugated catecholamines or free Catecholamines.For the diagnosis of Medullary Ca Thyroid aspiration is done of Thyroid Nodule. 