24. Pheochromocytoma Flashcards Preview

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Flashcards in 24. Pheochromocytoma Deck (24):
1

MC tumor of the adrenal medulla in adults

pheochromocytoma

2

pheochromocytoma - derived from

chromaffin cells ( neural crest)

3

pheochromocytoma - 5 chatacteristics

rule of 10s
110% malignant
10% bilateral
10% extra-adrenal
10% calcify
10% kids

4

pheochromocytoma - benign or malignant

benign
but 10% malignant

5

pheochromcytoma - bilateral or unilateral

unilateral
but 10% bilateral

6

adults or kids

MC tumor of the adrenal medulla in adults
but 10% in kiew

7

pheochromocytoma - adreanal or extre adrenal?

adrenal
but 10% extradrenal

8

pheochromocytoma - findinfs ( lab)

increased catecholamines and metanephrines in urine and plasma

9

VMA

Vanillymandelic acid

10

pheochromocytoma - most tumors secrete

1. epinephrine
2. norepinephrine
3. dopamine

11

pheochromocytoma - most tumors secrete ... which can cause ...

1. epinephrine
2. norepinephrine
3. dopamine

EPISODIC HYPERTENSION

12

pheochromocytoma - symptoms occur in ( time ...)

in spells ( relapse and remits)

13

pheochromocytoma - episodic hyperadrenergic symptoms

MNEMONIC : 5Ps
Pressure ( inccreased BP)
Pain ( headache)
Perspiration
Pallor
Palpitatation (tachycardia)

14

pheochromocytoma is associated with

--> up to 25% of cases are asspcoated with germline mutations
1 . neurofibromatosis type 1
2. von Huppel - Lindau disease
3. RET ( MEN 2A, MEN 2B)

15

pheochromocytoma - treatment

irreversible α - antagonists followed by β - blockers prior to resection

16

irreversible α-antagonists

phenoxybenzamine

17

pheochromocytoma -α antagonists before β blockers - why

to avoid hypertensive crisis

18

pheochromocytoma - gross morphology

yellow -tan
can be hemorrhagic

19

On the basis of a history suggesting a chromaffin cell–derived adrenal tumor, you order serum/urine tests. What do you expect to find?

Increased catecholamines and metanephrines in both urine and plasma resulting from the presence of pheochromocytoma

20

List three genetic syndromes that are associated with pheochromocytoma.

Multiple endocrine neoplasia types 2A and 2B, neurofibromatosis, and von Hippel-Lindau syndrome

21

A 40-year-old woman presents with spells of high blood pressure, headache, sweating, palpitations, and pale skin. Treatment?

Required for pheochromocytoma treatment: irreversible α-antagonists (phenoxybenzamine) followed by β-blockade and, then, tumor removal

22

What are five common symptoms associated with pheochromocytoma?

5 P's: high blood Pressure, Pain (headache), Perspiration, Palpitations (tachycardia), Pallor

23

List the five components of the pheochromocytoma rule of 10's.

10% malignant, 10% bilateral, 10% extra-adrenal, 10% calcify, 10% kids

24

What characteristic of a pheochromocytoma distinguishes it from chronic, poorly controlled hypertension?

Pheochromocytomas secrete epinephrine, norepinephrine, and dopamine, which cause relapsing and remitting symptom spells