pheochromo

Question 1

vascular tumor of chromaffin tisue ( adrenal medulla) produces NE and E

Answer 1

pheo

Question 2

abn high levels of NE and E

Answer 2

Pheo

Question 3

urinary excretion of VMA ( end product of catacholamine met) , NE and E are incrased

Answer 3

Pheo, diagnosis

Question 4

elev levels of urinary metanephrines and catacholamins

Answer 4

accurate diagnosis

Question 5

fractonated plasma free metanephrine levels

Answer 5

superior to urinary metanephrine

Question 6

CT /MRI with or without contrast

Answer 6

determination of tumor

Question 7

alpha cstimulation - PVR increases, depletion of IV volume by HTN, renal failure , cerebral hemorrhage, Myocardial hemorhage, vent hypertrophy, CHF, catacholamine induced Hypertrophy,

Answer 7

pathophysiology of CV chronic elev of catacholamines

Question 8

hyperglycemia - dec insulin production, increased gluconeogenesis, glycogenolysis

Answer 8

other endocrine effect of Pheo

Question 9

increases automaticity and vent ectopy

Answer 9

B1 stimulation.

Question 10

A 1 antagonisits , revereses increased PVR, restores Volume and hematocrit

Answer 10

phenoxybenezamine

Question 11

another a 1 antagonisits, shorter acting

Answer 11

phentolamine

Question 12

oral , longer acting alpha 1 antagonisits , given preop

Answer 12

phenoxy

Question 13

to control hypertensive crisis

Answer 13

IV phentolamine

Question 14

slow onset and longer duation of action , tachyphylaxis develops, IV

Answer 14

phentolamine

Question 15

tumor but has tachycardia and vent arrythmia

Answer 15

B1 blockade w labetalol

Question 16

if b1 receptors are blocked first , unopposed NE and E will produce alpha 1 stim

Answer 16

use alpha1 blockade first

Question 17

pheochromacytoma treated only w labatelol

Answer 17

paradoxical HTN

Question 18

succ induced abd musculature will increase abd pressure

Answer 18

must be avoided (theoretical)

Question 19

vol anesthetic induces arrythmogenic effects

Answer 19

halothane

Question 20

worsen imbalance of autonomic tone

Answer 20

vagolytic drugs ( anticholinergics and pancuronium

Question 21

histamine drug provokes catacholamine secretion by tumor.

Answer 21

atracurium, best avoided

Question 22

vecuronium , rocuronium

Answer 22

DOC in Pheo

Question 23

could block sensory ( afferent ) nerves and sympathetic ( efferent) discharge in the area of surgical field. but surgical manipulation can still activate adrenergic receptors.

Answer 23

regional block ( spinal and epidural)