pheochromocytoma

Question 1

pheochromocytoma

Answer 1

tumor of adrenal medulla. comes from neuroectoderm. not like the cortex. rare. 50% benign. signs from catecholamine secretion or postcaval obstruction

Question 2

clinical signs

Answer 2

hormons. paroxysmal: anxiety, mental depression, restlessness, panting. paroxysmal blaching and flushing. tachycardia, arrythmias, vpcs, chf, paroxysmal weakness and/or collapse. ascites.

Question 3

pheo dx

Answer 3

rule these things out first- hypoglycemia, cardiac disease, cerebral dysfunction, hyperthyroidism. hx might wax and wane if secreting catecholamine.

Question 4

dx of canine pheo

Answer 4

hx, PE, imaging, blood pressure measurements, strong index of clinical suspicion. elevated urinary normetanephrine- recently reported. unexplained tachycardia sometimes presents. ascites. radiology helpful.

Question 5

phenoxybenzamine

Answer 5

alpha adrenergic blocker. lowers blood pressure.

Question 6

pheo rx

Answer 6

surgery. medical- phenoxybenzamine0 alpha blockade. regitine- phentolamine- alpha blocker. propranolol- beta block. alpha block first beta block second. to avoid massive hypertensive swing.

Question 7

take home messages

Answer 7

signs from episodic sympathetic surges or postcaval obstruction. radiographs, ultrasond, ct scan. hypertension, tachyarrythmias. phenoxybenzamine. alpha before beta.