adrenals Flashcards
phaeochromocytoma: list the clinical features and explain the management of a patient with a phaeochromocytoma
what are phaeochromocytomas
adrenal medulla tumours which secrete catecholamines (e.g. adrenaline, noradrenaline)
effect of phaeochromocytomas
intermittent episodes of sudden attack, increasing blood pressure which can cause heart attack or stroke; also very anxious
clinical features of a phaeochromocytoma
hypertension in young people, episodic severe hypertension (after abdominal palpation as release of adrenaline); more common in certain inherited conditions (can search for before symptoms shows)
effect of severe hypertension caused by a phaeochromocytoma
can cause myocardial infarction or stroke
effect of high adrenaline caused by a phaeochromocytoma
can cause ventricular fibrillation and death
management of phaeochromocytomas
eventually will need surgery, but patient must have careful preparation as anaesthetic can precipitate hypertensive crisis
what is the first therapeutic step when managing a phaeochromocytoma
alpha blockade (may need i.v. fluid as alpha blockade commences to prevent severe fall in blood pressure)
why is a beta blockade added when initally managing a phaeochromocytoma with an alpha blockade
prevents tachycardia
phaeochromocytoma: % extra-adrenal in sympathetic chain
10
phaeochromocytoma: % malignany
10
phaeochromocytoma: % bilateral
10
phaeochromocytoma: prevalence
extremely rare
