Phaeochromocytoma

Question 1

[…] secreting tumour that arises from the […] cells (aka phaeochromocytes) of the adrenal […] and […] ganglia –> excess […]

Phaeochromocytoma if it arises in the […] […]

[…] if it arises in sympathetic nerve tissue elsewhere in the body.

Answer 1

catecholoamine, chromaffin, medulla, sympathetic, adrenaline

adrenal medulla
PARAGANGLIOMA

Question 2

Clinical features
[…] (around 90% of cases, may be sustained)
[…]
sweating
tachycardia

Answer 2

hypertension
headaches

Question 3

Precipitants

Answer 3

stress
exercise
surgery
straining and various drugs such as beta blockers
anaesthetic agents and opiates.

Question 4

Invx
24hr urinary […] have the best diagnostic accuracy (OR 24 hour urinary […], although not as good)

Imaging: […] -paragangliomas can arise from base of […] to […]

Answer 4

metanephrines, catecholamines
CTCAP, brain, bladder

Question 5

Mx

Answer 5

Definitive - surgical resection

alpha-blocker (e.g. phenoxybenzamine)
THEN
beta-blocker (e.g. propranolol) - prevent hypertensive crisis

Question 6

Why does phaeo present with hypokalaemia

Answer 6

stimulation of beta 2 receptors causing activation of sodium potassium-ATPase in skeletal muscles and subsequent intracellular shift of potassium