HTN

Question 1

Name 6 endocrine causes of hypertension.

Answer 1

1. Acromegaly
2. Hypothyroidism (diastolic)
3. Adrenal cortical disease: primary hyperaldosteronism
4. Adrenal cortical disease: Cushing
5. Adrenal medullary disease: pheochromocytoma
6. Exogenous - e.g. licorice, medications

Question 2

What is pheochromocytoma?

Answer 2

—~ Tumor arising from catecholamine-secreting
chromaffin cells of the adrenal medulla
~ Catecholamine hormones: derived from amino acid tyrosine
÷ Epinephrine
÷ Norepinephrine
÷ Dopamine

Question 3

What are the s/s of pheochromocytoma?

Answer 3

The typical patient has 3 symptoms: headache, diaphoresis and tachycardia.
~ HTN (sustained or episodic) most common clinical sign
~ Headache, diaphoresis, palpitations, most common symptoms

Question 4

When do you suspect pheochromocytoma? (5 P’s)

Answer 4

The “Five Ps of the Paroxysm”:
— Pressure (high BP)
— Pain (headache)
— Perspiration
— Palpitation
— Pallor

Question 5

What is the laboratory diagnosis of pheochromocytoma?

Answer 5

1) Serum and 24 hour urine for catecholamines.
2) Serum and 24 hour urine for metabolites of
catecholamines i.e. normetanephrine and
metanephrine

Question 6

Pheochromocytoma is always a problem with the adrenal gland.

T/F

Answer 6

False.
RARELY, there can be extra-adrenal catecholamine-secreting tumors of the
sympathetic ganglia, called paragangliomas

Question 7

How is pheochromocytoma treated?

Answer 7

Surgical excision of tumor