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PSBEDM Review > 16 Endocrine Hypertension > Flashcards

16 Endocrine Hypertension Flashcards

1
Q

Preoperative alpha adrenergic blockade should be started how many days preoperatively in the treatment of catecholamine-secreting neoplasms?

A

7-10 days

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2
Q

In the preoperative management of catecholamine-secreting neoplasms, longer therapy duration of alpha adrenergic blockade is indicated in the following (3)

A

Recent MI
Catecholamine CMP
Catecholamine-induced vasculitis

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3
Q

Target preoperative blood pressure in the treatment of catecholamine-secreting neoplasms

A

<120/80 mm Hg (seated)
>90 mm Hg SBP (standing)

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4
Q

High sodium diet is started on what day of alpha adrenergic blockade?

A

2nd or 3rd day

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5
Q

Target sodium content of diet during alpha adrenergic blockade

A

≥5 g/day

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6
Q

Reasons (2) why diet high in sodium is recommended during alpha adrenergic blockade

A

Catecholamine-induced contraction
Orthostasis associated with alpha adrenergic blockade

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7
Q

Possible contraindications to volume expansion during alpha blockade (2)

A

Congestive heart failure
Renal insufficiency

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8
Q

Beta adrenergic blockade is typically started how many days preoperatively for pheochromocytoma and paragangliona?

A

2-3 days preoperatively

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9
Q

Preferred drug for preoperative preparation to control blood pressure and arrhythmia in pheochromocytoma and paraganglioma

A

Phenoxybenzamine

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10
Q

Initial dosage for phenoxybenzamine in the preoperative preparation for catecholamine-secreting tumors

A

10 mg OD or BID

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11
Q

Maximum daily dosage for phenoxybenzamine in the preoperative preparation for catecholamine-secreting tumors

A

100 mg

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12
Q

Initial daily dosage for prazosin in the preoperative preparation for catecholamine-secreting tumors

A

1 mg

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13
Q

Maximum daily dosage for prazosin in the preoperative preparation for catecholamine-secreting tumors

A

20 mg

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14
Q

Initial daily dosage for terazosin in the preoperative preparation for catecholamine-secreting tumors

A

1 mg

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15
Q

Maximum daily dosage for terazosin in the preoperative preparation for catecholamine-secreting tumors

A

20 mg

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16
Q

Initial daily dosage for doxazosin in the preoperative preparation for catecholamine-secreting tumors

A

1 mg

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17
Q

Maximum daily dosage for doxazosin in the preoperative preparation for catecholamine-secreting tumors

A

20 mg

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18
Q

Pheochromocytoma and paraganglioma:
Alpha-adrenergic blocking agent given OD

A

Doxazosin

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19
Q

Pheochromocytoma and paraganglioma:
Alpha-adrenergic blocking agents given BID (2)

A

Terazosin
Phenoxybenzamine

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20
Q

Pheochromocytoma and paraganglioma:
Alpha-adrenergic blocking agent given TID-QID

A

Prazosin

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21
Q

Alpha-adrenergic blocking agent with first-dose effect (3)

A

Doxazosin
Prazosin
Terazosin

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22
Q

Alpha-adrenergic blocking agent with retrograde ejaculation as side effect

A

Phenoxybenzamine

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23
Q

Alpha-adrenergic blocking agents (3) with fatigue as side effect

A

Doxazosin
Phenoxybanzamine
Prazosin

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24
Q

Alpha-adrenergic blocking agents (2) with nasal congestion as side effect

A

Phenoxybenzamine
Terazosin

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25
Q

Alpha-adrenergic blocking agents (2) with somnolence as side effect

A

Doxazosin
Terazosin

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26
Q

Combined alpha and beta adrenergic blocking agent used to treat pheochromocytoma

A

Labetalol

27
Q

Maximum daily dosage for labetalol in the treatment of pheochromocytoma

A

1200 mg

28
Q

Initial daily dosage for labetalol in the treatment of pheochromocytoma

A

200 mg

29
Q

Maximum daily dosage for oral nicardipine in the treatment of pheochromocytoma

A

120 mg

30
Q

Initial daily dosage for oral nicardipine in the treatment of pheochromocytoma

A

30 mg

31
Q

Maximum daily dosage for metyrosine in the treatment of pheochromocytoma

A

4 g

32
Q

Initial daily dosage for metyrosine in the treatment of pheochromocytoma

A

1 g

33
Q

Oral drug used to treat pheochromocytoma with the ff side effects:
Sedation, diarrhea, anxiety, nightmares, crystalluria, galactorrhea, extrapyramidal symptoms

A

Metyrosine

34
Q

Adverse effects of pheoxybenzamine (4)

A

Orthostasis
Nasal congestion
Retrograde ejaculation
Marked fatigue

35
Q

Characteristics of phenoxybenzamine:
Irreversible / reversible
Long-acting / short acting
Nonspecific / specific
Alpha / beta blocking agent

A

Irreversible, long-acting, nonspecific alpha adrenergic blocking agent

36
Q

Pheochromocytoma should be suspected in the ff (9):

A

Hyperadrenergic spells
Resistant hypertension
Familial syndrome that predisposes to catecholamine-secreting tumors
Family history of pheochromocytoma
Incidentally discovered adrenal mass with imaging characteristics consistent with pheochromocytoma
Pressor response during anesthesia, surgery, or angiography
Onset of hypertension at a young age (<20 years)
Idiopathic dilated cardiomyopathy
Cyanotic congenital heart disease

37
Q

Onset of hypertension at what age should pheochromocytoma be suspected?

A

<20 years

38
Q

Typical imaging phenotypes of adrenal masses:
Size of cortical adenoma

A

<3 cm

39
Q

Typical imaging phenotypes of adrenal masses:
Size of cortical carcinoma

A

> 4 cm

40
Q

Typical imaging phenotypes of adrenal masses:
Size of pheochromocytoma

A

> 3 cm

41
Q

Typical imaging phenotypes of adrenal masses:
Tumor types that have round to oval shape with smooth margins (2)

A

Cortical adenoma
Pheochromocytoma

42
Q

Typical imaging phenotypes of adrenal masses:
Shape of cortical carcinoma

A

Irregular with unclear margins

43
Q

Typical imaging phenotypes of adrenal masses:
Shape of adrenal metastasis

A

Oval to irregular with unclear margines

44
Q

Typical imaging phenotypes of adrenal masses:
Texture of cortical adenoma

A

Homogenous

45
Q

Typical imaging phenotypes of adrenal masses:
Texture of cortical carcinoma

A

Inhomogenous

46
Q

Typical imaging phenotypes of adrenal masses:
Texture of pheochromocytoma

A

Inhomogenous with areas of cystic degeneration

47
Q

Typical imaging phenotypes of adrenal masses:
Texture of metastasis

A

Inhomogenous

48
Q

Typical imaging phenotypes of adrenal masses:
Laterality of cortical adenoma

A

Usually unilateral

49
Q

Typical imaging phenotypes of adrenal masses:
Laterality of cortical carcinoma

A

Usually unilateral

50
Q

Typical imaging phenotypes of adrenal masses:
Laterality of pheochromocytoma

A

Usually unilateral and solitary

51
Q

Typical imaging phenotypes of adrenal masses:
Laterality of adrenal metastasis

A

Often bilateral

52
Q

Typical imaging phenotypes of adrenal masses:
Tumor type with limited contrast enhancement

A

Cortical adenoma

53
Q

Typical imaging phenotypes of adrenal masses:
Tumor type with marked contrast enhancement (3)

A

Cortical carcinoma
Metastasis
Pheochromocytoma

54
Q

Typical imaging phenotypes of adrenal masses:
Precontrast CT attenuation and washout of cortical adenoma

A

<10 HU
>50% washout

55
Q

Typical imaging phenotypes of adrenal masses:
Precontrast CT attenuation and washout of cortical carcinoma

A

> 10 HU
<50% washout

56
Q

Typical imaging phenotypes of adrenal masses:
Precontrast CT attenuation and washout of pheochromocytoma

A

> 10 HU
<50% washout

57
Q

Typical imaging phenotypes of adrenal masses:
Precontrast CT attenuation and washout of metastasis

A

> 10 HU
<50% washout

58
Q

Typical imaging phenotypes of adrenal masses:
Tumor type that is isointense on MRI

A

Cortical adenoma

59
Q

Typical imaging phenotypes of adrenal masses:
Tumor type that is hyperintense on MRI (3)

A

Cortical carcinoma
Metastasis
Pheochromocytoma

60
Q

Typical imaging phenotypes of adrenal masses:
Tumor type where necrosis, hemorrhage, or calcifications are rare

A

Cortical adenoma

61
Q

Typical imaging phenotypes of adrenal masses:
Growth of cortical adenoma

A

Slow

62
Q

Typical imaging phenotypes of adrenal masses:
Growth of cortical carcinoma

A

Rapid

63
Q

Typical imaging phenotypes of adrenal masses:
Growth of pheochromocytoma

A

0.5-1 cm/yr

64
Q

Typical imaging phenotypes of adrenal masses:
Growth of metastasis

A

Variable

PSBEDM Review (20 decks)

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