Endocrinology - Phaeochromocytoma Flashcards Preview

Year 3 - Medicine Block 2 > Endocrinology - Phaeochromocytoma > Flashcards

Flashcards in Endocrinology - Phaeochromocytoma Deck (4)
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1
Q

from which cells do phaeochromocytomas arise from?

A

Chromaffin cells of adrenal medulla - secrete catecholamines

2
Q

describe the common signs and symptoms of phaeochromocytoma

A

Symptoms are intermittent - may occur from once a mnth to several times a day (tend to become more frequent and severe). Duration from secs to hrs.
i. headache
ii. profuse sweating
iii. palpitations
iv. tremor
+/- nausea, weakness, anxiety, epigastric/flank pain, weight loss

Signs:

i. HTN (may be paroxysmal)
ii. postural hypotension
iii. tremor

3
Q

which Ix would you request for someone with suspected phaeochromocytoma?

A

Bloods:

  • plasma catecholamines and plasma metanephrines: raised
  • Hb: raised (due to haemoconcentration from decreased circulating volume)
  • UandEs: may have hypercalcaemia
  • plasma glucose: often raised

Bedside tests:

  • 24 hr urine collection (pref. straight after crisis): total catecholamines, vanillymandelic acid and metanephrines
  • BP: ?HTN or postural hypotension
  • ECG: ?arrythmia

Imaging (after biochemical confirmation of tumour):
- CT scan thorax/abdo/pelvis +/- MRI for locating mets and possible extra-adrenal phaeochromocytomas

Other:

  • genetic testing: if appropriate
  • histology: ?benign vs malignant
4
Q

how would you manage a pt with phaeochromocytoma?

A

Pre-op:
1. a- or B-blockers required to control BP and prevent intra-operative hypertensive crisis. a-blockade with PHENOXYBENZAMINE started at least 7-10 days pre-op to allow expansion of blood volume. Once this is achieved, B-blockers can be considered.

  1. Surgical resection of tumour - usually results in cure of HTN.