Nurse Practitioner

Card Set Information

Author:
northlover
ID:
48105
Filename:
Nurse Practitioner
Updated:
2010-11-08 07:58:26
Tags:
Endocrine
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Description:
Pheochromocytoma
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  1. Pheochromocytoma
    A rare but serious disease resulting from excess catecholamine release characterized by paroxysmal or sustained hypertension, almost always due to a tumor of the adrenal medulla
  2. Pheochromocytoma - s/s
    • Hypertension
    • Diaphoresis
    • Hyperglycemia
    • Severe headaches
    • Palpitation, profuse sweating
    • Tremor
    • Tachycardia
    • Weight loss
    • Postural hypotension
  3. Pheochromocytoma - laboratory diagnostics
    • TSH is normal
    • May be hyperglycemic or glycosuric
    • Plasma-free metanephrines:
    • - plasma concentration of normetanephrines>2.5, or
    • metaneprhine levels >1.4
    • Assay of urine catecholamines, metanephrines, vanillylmandelic acid and creatinine. 24 hour urine ?2.2 metanephrine per mg creatinine and >5.5 mg VMA per mg creatininte
    • CT and MRI of adrenals used to confirm or localize tumor
  4. Pheocromocytoma management
    • 1. Surgical removal of tumor is treatment of choice
    • 2. Alpha adrenergic medication preoperatively may be used
    • - Phentolamine (Regitine)
    • - as soon as possible, convert to PO phenoxybenzamine
    • 3. Postoperatively, watch for:
    • - Hypotension (depleted catecholamines)
    • -adrenal insufficiency
    • -Hemorrhage

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