Phaeochromocytoma Flashcards Preview

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Flashcards in Phaeochromocytoma Deck (10):
1

what is it

rare catecholamine producing tumour

2

what does it arise from

arise from sympathetic paraganglia cells - collection of chromaffin cells. usually found within the medulla. extra renal tumours rarer (by aortic bifurcation)

3

what are 90% due to

sporadic

4

what are 10% due to

part of hereditary cancer syndromes, eg thyroid, MEN-2a and 2b, neurofibromatosis, von Hippel Lindau

5

what is the classic triad

episodic headache, sweating, tachycardia

6

tests

WCC, plasma and urines for free metadrenaline and normetadrenaline. localisation- CT/MRI. of MIBG chromaffin seeking isotrope scan

7

treatment

a blockade pre op, b blockers if heart disease or tachycardic, post op- urine metadrenalines.

8

emergency what do you do

combined a and b blockade, long acting a blocker eg phenoxybenzamine. b blocker. surgery for full alpha blockade and volume expansion

9

what happens in a phaeochromocytoma crisis

acute hypertensive crises- exacerbated symptoms by stress, abdo palpation, parturition, general anaesthetic, contrast media used in imaging

10

signs in crisis

pallor, pulsating headache, hypertension, feels 'about to die', pyrexial. ECG- signs LVF, incr ST segment, VT and cardiogenic shock