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Pheochromocytoma
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Pheochromocytoma

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Questions and Answers

Which of the following is a potential complication for patients with pheochromocytomas during intubation and extubation?

  • Hypertension
  • Tachycardia (correct)
  • Bradycardia
  • Hypoglycemia

    • Why might dexmedetomidine be a beneficial choice for patients with pheochromocytomas?

  • Causes hypercarbia
  • Induces hypotension (correct)
  • Increases sympathetic outflow
  • Triggers anxiety

    • Which class of drugs does dexmedetomidine belong to?

  • Calcium channel blockers
  • Beta blockers
  • Alpha-2 agonists (correct)
  • Sympathomimetic drugs

    • Why should stress, fear, and anxiety be minimized in patients with pheochromocytomas?

    <p>To avoid catecholamine release</p> Signup and view all the answers

    What is the primary clinical effect of dexmedetomidine mentioned in the text?

    <p>Hypotension</p> Signup and view all the answers

    Which receptor does dexmedetomidine selectively bind to?

    <p>Alpha-2 adrenergic receptor</p> Signup and view all the answers

    Why should a non-selective beta blocker never be used before alpha blockade is established?

    <p>It may result in profound vasoconstriction due to unopposed alpha agonism</p> Signup and view all the answers

    Which medication can be used along with alpha blockers to control hypertension in patients with pheochromocytoma?

    <p>Calcium channel blockers</p> Signup and view all the answers

    Why is it important to avoid drugs or maneuvers that may stimulate catecholamine release during anesthesia management?

    <p>To prevent hypertensive crisis</p> Signup and view all the answers

    Which of the following is a common cause of dramatic hemodynamic changes during the intraoperative management of a patient with pheochromocytoma?

    <p>Abrupt changes in position</p> Signup and view all the answers

    Which type of anesthetic depth adjustment is typically required to manage arrhythmias in patients with pheochromocytoma?

    <p>Increased anesthetic depth</p> Signup and view all the answers

    What is the purpose of using sodium nitroprusside, phentolamine, nitroglycerine, labetalol, and magnesium sulfate in patients with pheochromocytoma?

    <p>To manage hypertension</p> Signup and view all the answers

    What is the classic symptom triad in a patient with pheochromocytoma?

    <p>Paroxysmal diaphoresis, tachycardia, and headache</p> Signup and view all the answers

    What is the main catecholamine associated with systolic/diastolic hypertension and reflex bradycardia in pheochromocytoma?

    <p>Norepinephrine</p> Signup and view all the answers

    What is the genetic origin associated with 20-35% of pheochromocytoma cases?

    <p>Familial pheochromocytoma/paraganglioma syndrome</p> Signup and view all the answers

    Which alpha blocker is commonly used for preoperative preparation in pheochromocytoma?

    <p>Phenoxybenzamine</p> Signup and view all the answers

    What is the alternative pure alpha-1 blocker that can be used if tachycardia occurs after alpha blockade with phenoxybenzamine?

    <p>Prazosin</p> Signup and view all the answers

    What surgical correction is curative in 90% of pheochromocytoma patients?

    <p>Surgical manipulation of tumor</p> Signup and view all the answers

    Which medication can be used to control blood pressure, intravascular fluid restoration, and symptoms before surgery in pheochromocytoma?

    <p>Phenoxybenzamine</p> Signup and view all the answers

    Which medication can be used if tachycardia persists after alpha blockade with phenoxybenzamine?

    <p>Esmolol</p> Signup and view all the answers

    Which class of medication plays a role in managing blood pressure during anesthesia & surgery for patients with pheochromocytoma?

    <p>Alpha blockers</p> Signup and view all the answers

    Which monitoring technique is essential for early intervention during anesthesia for patients with pheochromocytoma?

    <p>Electrocardiogram (ECG)</p> Signup and view all the answers

    Why should a non-selective beta blocker never be used before alpha blockade is established in patients with pheochromocytoma?

    <p>It may cause unopposed alpha agonism.</p> Signup and view all the answers

    What is the purpose of using calcium channel blockers in controlling hypertension in patients with pheochromocytoma?

    <p>To manage catecholamine-induced hypertension.</p> Signup and view all the answers

    During anesthesia management for pheochromocytoma, what can help in minimizing abrupt changes in position to prevent tumor stimulation?

    <p>Increased anesthetic depth</p> Signup and view all the answers

    Which medication should be avoided before tumor removal during anesthesia management for pheochromocytoma?

    <p>Histamine-releasing agents</p> Signup and view all the answers

    What should be prevented by avoiding drugs or maneuvers that stimulate catecholamine release during anesthesia management for pheochromocytoma?

    <p>Tumor stimulation</p> Signup and view all the answers

    Which of the following is a potential effect of using sodium nitroprusside, phentolamine, nitroglycerine, labetalol, and magnesium sulfate in patients with pheochromocytoma?

    <p>Managing hypotension</p> Signup and view all the answers

    What should be avoided to prevent catecholamine release and resultant hemodynamic changes during anesthesia management for pheochromocytoma?

    Signup and view all the answers

    Why is it crucial to apply alpha blockers such as phenoxybenzamine before surgery in patients with pheochromocytoma?

    <p>To control blood pressure, intravascular fluid restoration, and symptoms</p> Signup and view all the answers

    Why is it not recommended to use a non-selective beta blocker without prior alpha blockade in patients with pheochromocytoma?

    <p>To avoid profound hypertension</p> Signup and view all the answers

    Which of the following adjustments in anesthesia management is crucial to handle catecholamine-induced cardiovascular changes in patients with pheochromocytoma?

    <p>Implementing monitoring techniques for early intervention</p> Signup and view all the answers

    What is the primary consideration for using endotracheal intubation in patients with pheochromocytoma during anesthesia?

    <p>Maintaining stable blood pressure</p> Signup and view all the answers

    Which surgical manipulation is curative in 90% of patients with pheochromocytoma?

    <p>Ligation of tumor blood supply</p> Signup and view all the answers

    Why should drugs that stimulate catecholamine release be avoided in anesthesia management for patients with pheochromocytoma?

    <p>Because they can trigger hypertensive crises</p> Signup and view all the answers

    What is the main purpose of using selective alpha-1 blockers like prazosin and doxazosin before surgery for patients with pheochromocytoma?

    <p>For symptom control and intravascular fluid restoration</p> Signup and view all the answers

    Why is it important to quickly respond to catecholamine-induced changes in cardiovascular function during anesthesia for patients with pheochromocytoma?

    <p>To manage hemodynamic instability</p> Signup and view all the answers

    Which medication is commonly used after alpha blockade with phenoxybenzamine to control tachycardia in patients with pheochromocytoma?

    <p>Labetalol</p> Signup and view all the answers

    What is the alternative pure alpha-1 blocker that can be used if tachycardia occurs after alpha blockade with phenoxybenzamine?

    <p>Prazosin</p> Signup and view all the answers

    Why should a non-selective beta blocker never be used before alpha blockade is established in patients with pheochromocytoma?

    <p>To avoid exacerbating hypertension</p> Signup and view all the answers

    Which class of medications plays a critical role in managing blood pressure, intravascular fluid restoration, and symptoms before surgery in pheochromocytoma?

    <p>Alpha-2 agonists</p> Signup and view all the answers

    Why is it important to avoid drugs or maneuvers that may stimulate catecholamine release during anesthesia management for patients with pheochromocytoma?

    <p>To prevent hypertensive crisis</p> Signup and view all the answers

    What is the main reason stress, fear, and anxiety should be minimized in patients with pheochromocytomas?

    <p>To reduce catecholamine secretion</p> Signup and view all the answers

    Which receptor does dexmedetomidine selectively bind to for its clinical effects in patients with pheochromocytomas?

    <p>Alpha-2 adrenergic receptors</p> Signup and view all the answers

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