Pheochromocytoma: Diagnosis and Treatment
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Questions and Answers

What is the primary treatment method for pheochromocytoma?

  • Radiation therapy
  • Surgery (correct)
  • Hormonal therapy
  • Chemotherapy

    • What is the role of genetic testing in patients with pheochromocytoma?

  • It should only be performed in older patients
  • It should be performed in all confirmed cases (correct)
  • To determine the operability of the tumor
  • To assess the response to surgery

    • When administering medical treatment for pheochromocytoma, which statement is true regarding β blockers?

  • Unopposed α action may lead to hypertensive crisis if initiated first (correct)
  • They are contraindicated prior to surgery
  • They should be started without a history of α blocker use
  • They can be used alone without concerns of complications

    • In the context of pheochromocytoma surgery preparation, what is the recommended timing for initiating medical treatment?

    <p>A few weeks before surgery</p> Signup and view all the answers

    Which imaging technique may aid in the localization of pheochromocytomas?

    <p>Positron Emission Tomography (PET)</p> Signup and view all the answers

    Which symptom is NOT considered part of the '6 Ps' related to paroxysmal conditions?

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

    Which of the following symptoms is explicitly indicated as a type of paroxysmal event?

    <p>Paroxysmal sweating</p> Signup and view all the answers

    Which term does NOT belong to the grouping of common presentations in paroxysmal conditions?

    <p>Chronic insomnia</p> Signup and view all the answers

    Which cause of death is NOT commonly associated with pheochromocytomas?

    <p>Benign hypertension</p> Signup and view all the answers

    What is the primary focus of the symptoms identified in paroxysmal conditions?

    <p>Intermittent increases in blood pressure</p> Signup and view all the answers

    Which of the following symptoms is associated with paroxysmal tachycardia?

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

    Which laboratory investigation method is specifically used to assess sympathetic activity in pheochromocytomas?

    <p>Radioisotope scanning with MIBG</p> Signup and view all the answers

    What is the most useful method for detecting paroxysmal secretion in catecholamines?

    <p>24-hour urinary collection for metanephrines</p> Signup and view all the answers

    Which of these factors does NOT categorize as a mode of death for pheochromocytomas?

    <p>Cardiac arrest during anesthesia</p> Signup and view all the answers

    Which of the following statements regarding investigation of pheochromocytomas is accurate?

    <p>CT scan is primarily for locating the tumor.</p> Signup and view all the answers

    Study Notes

    Positron Emission Tomography (PET)

    • Used for localization of pheochromocytomas.

    Genetic Testing

    • Performed in all individuals with confirmed pheochromocytoma or paraganglioma.

    Treatment

    • Surgery: Treatment of choice.
    • Medical: Combined α & β blockers.
      • Starting with β blockers without α blockers can lead to hypertensive crisis.
    • Medical treatment should be initiated several weeks before surgery.
    • Myocardial infarction
    • Cerebrovascular accident
    • Arrhythmias
    • Renal failure
    • Dissecting aortic aneurysm
    • Acute respiratory distress syndrome (ARDS)
    • Irreversible shock

    Investigation

    • Urinary Valenyle Mandelic Acid (VMA): Part of diagnostic testing.
    • Urinary catecholamine:
      • Metabolite (metanephrines)
      • 24-hour urinary collection preferred due to paroxysmal secretion.
    • Plasma catecholamine: Part of diagnostic testing
    • CT scan, MRI for abdomen: Used for imaging.
    • Radioisotope scanning:
      • Meta Iodo Benzyl Guanidine (MIBG) scanning shows specific uptake in areas of sympathetic activity.
      • Increased uptake likely indicates elevated levels.

    Clinical Presentation

    • Paroxysmal hypertension: Sudden, temporary increases in blood pressure.
    • Paroxysmal headache: Sudden, temporary severe headaches.
    • Paroxysmal sweating: Sudden, temporary episodes of excessive sweating.
    • Paroxysmal tachycardia (palpitation): Sudden, temporary rapid heart rate.
    • Anxiety & psychiatric disturbance: Increased anxiety and mood changes.

    6 Ps

    • Palpitation: Rapid heartbeat
    • Pallor: Pale skin
    • Perspiration: Excessive sweating
    • Pain (headache): Sudden severe headaches
    • Paroxysmal increase in blood Pressure: Sudden temporary increase in blood pressure.
    • Psychiatric disturbance (Anxiety, Panic attacks): Increased anxiety and panic attacks.

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    Description

    This quiz covers the essential aspects of pheochromocytomas including diagnostic tests such as Positron Emission Tomography (PET) and genetic testing, as well as the preferred treatment options. Understand the critical causes of death related to this condition and the proper investigation methods essential for management.

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