Endocrine - Adrenal Medulla

Question 1

What does the Adrenal Medulla deal with ?

Answer 1

Epinephrine & Norepinephrine

Question 2

Where are the Adrenal Glands located ?

Answer 2

On top of the Kidneys

Question 3

What is an Adrenal Medulla Problem ?

Answer 3

Pheochromocytoma

Question 4

What is Pheochromocytoma ?

Answer 4

Benign tumors that secrete epi and norepi in boluses

Question 5

Does Pheochromocytoma tend to be familial ?

Answer 5

Yes (so screen the family)

Question 6

What are s/s of Pheochromocytoma (Adrenal medulla problem) ?

Answer 6

• Increased BP
• Increased HR
• Increased palpitations
• Flushed/extremley diaphoretic
• Headaches
• Triad of symptoms
  pounding headache
  tachycardia
  profuse sweating

Question 7

How do you diagnose Pheochromocytoma (Adrenal medulla problem) ?

Answer 7

Catecholamine levels

Question 8

What tests do you use to detect catecholamine levels in patients with pohechromocytoma ?

Answer 8

• VMA test (vanillymandelic acid)
  OR
• MN test (metanephrine)

Question 9

What do these 2 tests tell us ?

• VMA test OR MN test

Answer 9

Tell if epi/norepi levels are elevated

Question 10

Which of the two test used for diagnosing Pheochromocytoma is most common ?

Answer 10

MN test (Metanephrine)

Question 11

The MN (Metanephrine) test is altered by what ?

Answer 11

Caffeine

Question 12

What are foods/drinks that alter the VMA (Vanillymandelic) test ?

Answer 12

• Anything with vanilla in it
• Vitamin B
• Fruit juices
• Bananas

Question 13

What is another way to diagnose Pheochromocytoma ?

Answer 13

A 24 hour urine specimen

Question 14

What is a 24 hour urine specimen screening for when trying to diagnose pheochromocytoma ?

Answer 14

Screening for increased levels of Epi and Norepi

also called catecholamines

Question 15

What should you do with the first and last urines when completing a 24 hour urine specimen ?

Answer 15

First void = throw away

Last void = keep

Question 16

What are other ways that pheochromocytoma might be diagnosed aside from VMA/MN test & 24 hour urine tests ?

Answer 16

CT/MRI scans ( to detect the tumor)

Question 17

In patients with Pheochromocytoma, what should be avoided ?

Answer 17

Any activities that increase epi and norepi (NO stress!)

Question 18

What is the Treatment for Pheochromocytoma ?

Answer 18

Surgery, to remove the tumors

Question 19

ALERT:

What should you avoid doing in a patient with a suspected pheochromocytoma ? and why ?

Answer 19

Avoid palpating the abdomen

Because, it may cause a sudden release of catecholamines and severe hypertension