Pheochromocytoma Flashcards
1
Q
Classic Presentation Symptoms
A
- HA. sweating, palpitations
- anxiety, tremor
- pallor, flushing
- chest pain, epigastric pain
- painless hematuria
- HTN
2
Q
What are the six Hs of pheo?
A
- HTN
- HA
- hyperhidrosis (excess weating)
- heart consciousness/palpitations
- hypermetabolism
- hyperglycemia
3
Q
What is the etiology of pheo (rule of 10)?
A
- 10% familial
- 10% malignant
- 10% multiple or bilateral
- 10% extra-adrenal
- 10% childhood onset
- 10% recurrence after surgery
4
Q
Labs for Pheo
A
- plasma free metanephrines: 99% sens and 89% spec
- urine metaneprines (24 hr collection): 76% sens, 94% spec
5
Q
Rarely Used Tests for Pheo
A
- urinary VMA
- plasma catecholamines
6
Q
Tumor Localization
A
- adrenal CT or MRI: 93-100% sens, 70% spec
- MIGB scan: 77-90% sens, 95-100% spec; good for looking for tumors in unusual places
7
Q
Preoperative Pheo Management
A
- alpha adrenergic receptor antagonist
- beta blocker
8
Q
Indications for Pheo Laparoscopic Surgery
A
- single, small adrenal tumors
- HTN controlled
9
Q
Indications for Pheo Open Adrenalectomy Surgery
A
-adrenal tumor over 7 cm
