Endocrine disorder- Pheochromocytoma

Answer 1

results from excessessive catecholamine (epi/norepi), characterized by a paroxsymal (sudden start/stop) or sustained hypertension. almost always due to a tumor of the adrenal medulla

Question 2

sls

Answer 2

Labile hypertention
diaphoresis
hyperglycemia
severe headaches
tachycardia
tremor
postural hypotension

Question 3

labs/diagnostics

Answer 3

• TSH normal (FIRST test )
• plama free metanephrines

Question 4

4 urine Assay test for diagnosing pheochromocytoma

Answer 4

1. urine catechololamines (total and unfractionated)
2. metanephines
3. vanillymandelic acid (VMA)
4. Creatinine

Question 5

How to test the urine catecholamine assays

Answer 5

24 hr urine

Question 6

what is the confirmatory test for pheochromocytoma

Answer 6

CT of adrenals to confirm or localize tumor

Question 7

Management of pheochromocytoma

Answer 7

• surgical removal is the treatment of choice

alpha adrenergic meds PRE-OP
- phentolamine (Regitine) 1-2 mg IV every 5 min…then 1-5 mg every 12-24 hrs

ASAP convert to PO Phenoxybenzamine (Dibenzyline)

Question 8

what to watch out for post op

Answer 8

• hypotension (depleted catecholamines)
• adrenal insufficiency
• Hemorrhage