醫學筆記匯整 ED Notes

Chromaffin cells tumor from Adrenal medulla & Sympathetic paraganglia
Excess of catecholamines

5P symptoms 
 - Pressure : Paroxysmal in 50%, Resistance to treatment
 - Pain : Headache, Chest pain
 - Palpitation : Tachycardia, Weight loss, Fever
 - Perspiration
 - Pallor
 

Rule of 10 

 - Extra-adrenal (Paraganglioma)
 - Children
 - Multiple or bilateral
 - Recurrence
 - Malignant
 - Familial
 - Incidentaloma

Diagnosis
CT, MRI : Adrenal mass
Urinary / Blood catecholamines test,   Metanephrines test,   Vanillylmandelic acid test (VMA)
MIBG scan, PET scan 


Treatment

Alpha blockade +/- beta blocker 
 - Beta blocker should be paired with a vasodilator   
 - Beta blocker are used for HR control after alpha blockade
 - Alpha blockade : Doxazosin

CCB
Surgery