<prompt> A patient presented with headache and flushing. He has a family history of his relative having died of a Medullary ca of thyroid. . The investigation that would be required for this patient would be:Chest X-rayMeasurement of 5 HIAAFractionated plasma metanephrinesIntravenous pyelography  <response>: Diagnosis is MEN-2 Syndrome Pt is having symptoms of Pheochromocytoma MEN-2- Aka MEN 2A Sipple syndrome- Autosomal dominant- Characterized by Medullary carcinoma thyroid Pheochromocytoma Parathyroid hyperplasia Adenoma Hirschsprung disease Cutaneous lichen amyloidosis- Gene responsible Mutation of RET oncogene located on chromosome 10 Mutated codon - Cysteine codon Investigations- Most sensitive Screening test - Urinary catecholamines VMA level- Best test for diagnosis - Fractionated plasma metanephrines- Radiological IOC for Adrenal pheochromocytoma- Radiological IOC for Extra adrenal pheochromocytoma MRI- Radiological IOC for pheochromocytoma in pregnancy- MIBG scan - useful for diagnosis of extra adrenal pheochromocytoma- FNAC and biopsy - contraindicated in pheochromocytoma as they can lead to hypeensive crisis 