pheochromocytoma

Question 1

define?

Answer 1

neuroendocrine tumor in the adrenal medulla arises from neural crest cells (chromaffin cells) and secretes catecholamines

Question 2

symptoms?

Answer 2

paroxysmal hypertension, palpitations, throbbing headache, sweating, pallor, tachycardia. all paroxysmal

Question 3

diagnosis?

Answer 3

free plasma metanephrines or 24hr urine metanephrines

ct abdomen

Question 4

treatment?

Answer 4

plan for adrenalectomy

preparation for surgery: control HTN and HR FIRST
1. start with alpha blocker (phenoxybenzamine/ doxazosin)

2. add beta blocker afterwards to control tachycardia (metoprolol/ propranolol)

both are done to reduce the risk of perioperative hypertensive crisis

to prevent post-op hypotension: high sodium and fluid intake