Pheochromocytoma
•Download as PPTX, PDF•
5 likes•4,610 views
A 35-year-old man presented with increasing headaches, palpitations, anxiety, and panic attacks over the past six months. His history and examination were consistent with possible conditions including anxiety disorders, hyperthyroidism, and pheochromocytoma. Pheochromocytoma was considered the most likely diagnosis given the classic signs and symptoms. Pheochromocytomas are rare catecholamine-secreting tumors that typically arise from the adrenal medulla or sympathetic ganglia. Diagnostic testing revealed elevated levels of catecholamines and metanephrines confirming the diagnosis of a pheochromocytoma. The patient was started on alpha- and beta-blockers in preparation for surgical removal of the tumor.
Report
Share
Report
Share
Recommended
Pheochromocytoma
Phreochromocytoma : overvew, introduction, adrenal gland anatomy and physiology, adrenl gland tumor classification, epidemiology, clinical features, investigations
Phaeochromocytoma
This document provides an overview of pheochromocytoma, which are rare catecholamine-producing tumors. Key points include:
- Pheochromocytomas arise from sympathetic nervous system and can be sporadic or inherited. Approximately 25% of cases are associated with genetic syndromes.
- Presentation involves classic triad of headaches, palpitations, and sweating along with hypertension. Diagnosis is confirmed through urine and plasma tests and imaging studies.
- Complete surgical removal is the primary treatment, with pre-operative medication to control blood pressure. About 10% of cases are malignant with distant metastases. Some pheochromocytomas are associated with genetic syndromes like VHL, MEN2, and
Phaeochromocytoma
A 29-year old man presented to the emergency room with crushing headaches and palpitations. Pheochromocytoma is a rare neuroendocrine tumor that secretes catecholamines and can cause hypertension. It arises from chromaffin cells of the adrenal medulla. Diagnosis involves urine or plasma tests to detect elevated catecholamines and imaging studies like MRI or MIBG scan to locate the tumor. Surgical removal is the primary treatment, along with pre-operative medication to control blood pressure. Lifelong monitoring is needed due to risk of recurrence.
Pheochromocytoma
Pheochromocytoma (PCA)
By Dr. Usama Ragab Youssif
Lecturer of Medicine Zagazig University
Pheochromocytoma and paraganglioma
Pheochromocytoma
The document discusses pheochromocytoma, a rare tumor of the adrenal glands that secretes excess catecholamines. It causes high blood pressure, headaches, increased heart rate and metabolic changes. Diagnosis involves testing urine and plasma catecholamine levels. Treatment includes alpha-blockers to lower blood pressure before surgery to remove the tumor. Nursing care focuses on monitoring vital signs and blood pressure to prevent hypertensive crises before and after surgery.
Pheochromocytoma management
This document discusses the diagnosis and management of pheochromocytoma. Key points include:
- Pheochromocytomas are rare catecholamine-secreting tumors that can cause hypertension. Diagnosis involves measuring plasma or urine metanephrines and imaging tests.
- Preoperative management aims to control blood pressure and prevent hypertensive crises during surgery. This involves alpha-blockade using drugs like phenoxybenzamine for 1-2 weeks before surgery.
- Surgery is the main treatment and involves an experienced multidisciplinary team. For inoperable or malignant tumors, nuclear medicine treatments or lifelong medical management may be used. Close postoperative monitoring is important.
Pheochromocytoma
This document discusses the diagnosis and treatment of pheochromocytoma, a catecholamine-secreting tumor of the adrenal medulla. It outlines the clinical presentation of hypertension, headache, and diaphoresis. It then describes a case of an incidentaloma found on CT scan and the workup to diagnose pheochromocytoma. Preoperative care involves beta-blockers and alpha-blockers. Surgical removal can be done laparoscopically using either a retroperitoneal or transabdominal approach, with different pros and cons for each. Postoperative care focuses on blood pressure management and long-term follow up to monitor for recurrence.
Pheochromocytoma
Pheochromocytomas and paragangliomas are catecholamine- producing tumors derived from the sympathetic or parasympathetic nervous system.
Recommended
Pheochromocytoma
Phreochromocytoma : overvew, introduction, adrenal gland anatomy and physiology, adrenl gland tumor classification, epidemiology, clinical features, investigations
Phaeochromocytoma
This document provides an overview of pheochromocytoma, which are rare catecholamine-producing tumors. Key points include:
- Pheochromocytomas arise from sympathetic nervous system and can be sporadic or inherited. Approximately 25% of cases are associated with genetic syndromes.
- Presentation involves classic triad of headaches, palpitations, and sweating along with hypertension. Diagnosis is confirmed through urine and plasma tests and imaging studies.
- Complete surgical removal is the primary treatment, with pre-operative medication to control blood pressure. About 10% of cases are malignant with distant metastases. Some pheochromocytomas are associated with genetic syndromes like VHL, MEN2, and
Phaeochromocytoma
A 29-year old man presented to the emergency room with crushing headaches and palpitations. Pheochromocytoma is a rare neuroendocrine tumor that secretes catecholamines and can cause hypertension. It arises from chromaffin cells of the adrenal medulla. Diagnosis involves urine or plasma tests to detect elevated catecholamines and imaging studies like MRI or MIBG scan to locate the tumor. Surgical removal is the primary treatment, along with pre-operative medication to control blood pressure. Lifelong monitoring is needed due to risk of recurrence.
Pheochromocytoma
Pheochromocytoma (PCA)
By Dr. Usama Ragab Youssif
Lecturer of Medicine Zagazig University
Pheochromocytoma and paraganglioma
Pheochromocytoma
The document discusses pheochromocytoma, a rare tumor of the adrenal glands that secretes excess catecholamines. It causes high blood pressure, headaches, increased heart rate and metabolic changes. Diagnosis involves testing urine and plasma catecholamine levels. Treatment includes alpha-blockers to lower blood pressure before surgery to remove the tumor. Nursing care focuses on monitoring vital signs and blood pressure to prevent hypertensive crises before and after surgery.
Pheochromocytoma management
This document discusses the diagnosis and management of pheochromocytoma. Key points include:
- Pheochromocytomas are rare catecholamine-secreting tumors that can cause hypertension. Diagnosis involves measuring plasma or urine metanephrines and imaging tests.
- Preoperative management aims to control blood pressure and prevent hypertensive crises during surgery. This involves alpha-blockade using drugs like phenoxybenzamine for 1-2 weeks before surgery.
- Surgery is the main treatment and involves an experienced multidisciplinary team. For inoperable or malignant tumors, nuclear medicine treatments or lifelong medical management may be used. Close postoperative monitoring is important.
Pheochromocytoma
This document discusses the diagnosis and treatment of pheochromocytoma, a catecholamine-secreting tumor of the adrenal medulla. It outlines the clinical presentation of hypertension, headache, and diaphoresis. It then describes a case of an incidentaloma found on CT scan and the workup to diagnose pheochromocytoma. Preoperative care involves beta-blockers and alpha-blockers. Surgical removal can be done laparoscopically using either a retroperitoneal or transabdominal approach, with different pros and cons for each. Postoperative care focuses on blood pressure management and long-term follow up to monitor for recurrence.
Pheochromocytoma
Pheochromocytomas and paragangliomas are catecholamine- producing tumors derived from the sympathetic or parasympathetic nervous system.
Pheochromocytoma
Pheochromocytoma is a rare neuroendocrine tumor that originates in the chromaffin cells of the adrenal medulla. It secretes high amounts of catecholamines, mostly norepinephrine and epinephrine, which can cause symptoms like headaches, sweating, elevated blood pressure and heart rate. Up to 25% of pheochromocytomas are familial and associated with genetic mutations. While signs and symptoms vary, the most common presentation is headaches, sweating and increased heart rate. Diagnosis involves measuring catecholamines in blood or urine samples and imaging tests, while treatment is usually surgical removal of the tumor along with preoperative medication to control blood pressure.
Pediatric pheochromocytoma
This document provides information on pediatric pheochromocytoma including:
- Pheochromocytoma is a rare catecholamine-secreting tumor that arises from chromaffin cells and can cause hypertension.
- Diagnosis involves measuring plasma and urinary metanephrines and imaging studies to locate the tumor(s).
- Treatment requires preoperative medical management to control blood pressure followed by surgical resection, which usually cures the condition.
Pheochromocytoma
Pheochromocytoma is a catecholamine-producing tumor that arises from chromaffin cells of the sympathetic nervous system. It occurs in about 0.1-0.2% of hypertensive patients and can cause paroxysmal or sustained hypertension. Diagnosis involves measuring catecholamines or metanephrines in plasma or urine, which are elevated in most patients. Localization is typically done with CT or MRI imaging. Treatment involves pre-operative alpha-blockade to prevent hypertensive crises during tumor removal, followed by beta-blockers if needed. Complete surgical removal can cure patients if the tumor is benign.
PHEOCHROMOCYTOMA
Pheochromocytoma is a rare neuroendocrine tumor that originates from chromaffin cells of the adrenal medulla. It secretes high amounts of catecholamines, mostly epinephrine and norepinephrine. Symptoms include hypertension, headache, sweating, anxiety and weight loss. Diagnosis involves measuring catecholamines in blood and urine samples. Imaging tests like CT, MRI, MIBG scan and PET are also used. Preoperative treatment includes alpha-blockers to lower blood pressure. Surgical removal of the tumor is the primary treatment. Postoperative care focuses on blood pressure monitoring and managing stress.
Hypertensive encephalopathy
The hypertensive encephalopathy is a syndrome consisting of a sudden elevation of arterial pressure usually preceded by severe headache and followed by convulsions, coma or a variety of transitory cerebral phenomena.
Pheochromocytoma
1) A 15-year-old female presented with headaches, palpitations, and increased sweating. Imaging found a 5.7 cm mass in her right adrenal gland.
2) Biopsy of the removed mass confirmed pheochromocytoma. Pheochromocytomas are rare tumors that produce catecholamines, causing high blood pressure.
3) She was given alpha-blockers preoperatively to lower her blood pressure. A right adrenalectomy was performed to remove the tumor, and she required blood transfusions and medications post-surgery to manage her blood pressure before being discharged.
Hypopituitarism
This document provides an overview of hypopituitarism, including its anatomy, etiology, clinical features, diagnosis, and treatment. Hypopituitarism is a clinical syndrome of deficiency in pituitary hormone production and secretion that can result from disorders of the pituitary gland, hypothalamus, or surrounding structures. Common causes include tumors, trauma, infections, infiltrative disorders, and genetic mutations. Clinical features vary depending on which hormones are deficient but may include fatigue, weight changes, dry skin, and visual disturbances. Diagnosis involves hormonal blood tests and dynamic testing. Treatment is lifelong hormone replacement therapy to mimic normal hormone levels.
Prolactinoma
Prolactinomas are the most common pituitary tumors, accounting for 35-48% of cases. They cause hyperprolactinemia and symptoms like amenorrhea, galactorrhea, and infertility. Diagnosis involves hormonal tests, MRI of the pituitary, and visual field tests. Treatment options include dopamine agonists like cabergoline as first-line therapy. Surgery via transsphenoidal resection is also used and has low risks but high remission rates, especially for microadenomas. Radiation is reserved for larger residual or recurrent tumors.
Thyrotoxicosis, hyperthyroidism
Graves' disease is the most common cause of thyrotoxicosis, accounting for 60-80% of cases. It is an autoimmune disorder causing hyperthyroidism due to thyroid stimulating immunoglobulins that activate the TSH receptor. Symptoms include anxiety, heat intolerance, palpitations, weight loss and goiter. Treatment involves antithyroid medications, radioactive iodine therapy or surgery to control the hyperthyroidism. Radioactive iodine is often the preferred treatment option. Graves' disease can also cause eye changes and pretibial myxedema. Managing the condition during pregnancy requires careful titration of antithyroid medications.
Upper Gastrointestinal bleeding
This document provides an overview of acute gastrointestinal bleeding. It defines upper gastrointestinal bleeding and discusses its causes, including variceal and non-variceal sources. Signs and symptoms are outlined. The approach involves taking a thorough history and physical exam. Key lab tests include CBC, LFTs, coagulation panels and endoscopy. Treatment depends on the bleeding source, and may include endoscopic methods, radiological embolization, surgery, or medications like PPIs and vasoactive drugs. Complications are also reviewed.
Adrenal insufficiency
The adrenal glands secrete hormones that regulate metabolism, electrolyte balance, and stress response. The medulla secretes epinephrine and norepinephrine, while the cortex secretes steroids such as cortisol and aldosterone. Cortisol secretion follows a diurnal rhythm controlled by the HPA axis. Primary adrenal insufficiency results from failure of the adrenal glands, while secondary is a failure of the HPA axis. Presentation includes fatigue, weight loss, hypotension, and hyperpigmentation. Diagnosis involves short corticotropin stimulation tests. Treatment is with glucocorticoid replacement such as hydrocortisone.
Prolactinoma
This document outlines prolactinomas, which are the most common functional pituitary adenomas. It discusses the epidemiology, clinical manifestations, diagnosis, and treatment of prolactinomas. Prolactinomas are most frequently diagnosed in women between ages 20-50 and are caused by a prolactin-secreting tumor in the pituitary gland. Diagnosis involves assessing clinical symptoms, serum prolactin levels, and MRI imaging of the pituitary. Medical treatment with dopamine agonists is the primary treatment, with cabergoline being the first-line therapy due to its effectiveness and safety. Surgery and radiation are reserved for cases where medical treatment is ineffective or for large macroadenomas.
Hepatorenal syndrome
Hepato Renal Syndrome (HRS) is a form of kidney failure that occurs in patients with advanced chronic liver disease. It results from intense renal vasoconstriction caused by interactions between the systemic and portal circulatory systems. HRS has no underlying kidney pathology and typically develops spontaneously or in response to precipitating events like infections, bleeding, or large volume paracentesis. Diagnosis is based on criteria and HRS carries the worst prognosis of all liver disease complications. Treatment involves terlipressin and liver transplantation provides a definitive cure.
Hepatic Encephalopathy -Pathophysiology,Evaluation And Management
Hepatic encephalopathy is a brain dysfunction caused by liver disease or portosystemic shunting. It presents as a wide range of neurological or psychiatric abnormalities from mild alterations to coma. The prevalence is 30-40% in those with cirrhosis and risk of first episode is 5-25% within 5 years of cirrhosis diagnosis. Recurrence risk after an initial episode is 40% within 1 year. Ammonia, systemic inflammation, manganese, genetics, and oxidative stress may all contribute to pathogenesis. Diagnosis involves clinical exam and testing like serum ammonia levels or neuropsychological tests on phone apps. Management involves treating precipitating factors, lactulose, antibiotics like rifaximin, and
Cushing syndrome
This document discusses Cushing's syndrome, which results from high cortisol levels in the blood. It can be caused by exogenous glucocorticoid use, pituitary tumors, adrenal tumors, or ectopic ACTH-secreting tumors. Signs include central obesity, thin skin, high blood pressure, and bone weakness. Diagnosis involves screening tests like dexamethasone suppression tests and measuring ACTH and cortisol levels. If endogenous, further tests localize the source and guide treatment like surgery, radiation, or medication. The most common causes and their treatment approaches are summarized.
Addison disease by dr shahjada selim
- A 40-year-old patient presented with low-grade fever, coughing up blood, and weight loss. Tests showed signs of tuberculosis (TB) and the patient was started on anti-TB drugs. However, the patient died suddenly after 3 days of treatment.
- Addison's disease is a condition caused by insufficient production of hormones by the adrenal glands. It was first described by Dr. Thomas Addison in the 19th century. Common causes include autoimmune disease and TB infection of the adrenal glands.
- Without treatment, Addison's disease can cause low blood pressure, low blood sugar, high potassium levels, and even death. Treatment involves replacing glucocorticoid and
HYPERTENSION EMERGENCY & URGENCY
1. The document discusses hypertensive emergencies and urgencies, their causes, manifestations, evaluation, and management.
2. Initial evaluation involves assessing for target organ damage by examining cardiovascular, neurological, and renal systems. Laboratory tests and imaging help identify secondary causes and end-organ effects.
3. Intravenous antihypertensives like sodium nitroprusside, nicardipine, and labetalol are used to lower blood pressure in hypertensive emergencies to prevent further organ damage, while oral medications are preferred for urgencies.
renal tubular acidosis (RTA)
metabolic acidosis develops because of defects in the ability of the renal tubules to perform the normal functions required to maintain acid-base balance.
Interesting case presentation - PHEOCHROMOCYTOMA
Dr. P. Salamon Rajap G
Presented two interesting cases of Pheochromocytoma and discussed the importance of proper preoperative preparation to decrease morbidity and mortality for these types of tumors.
PPT on Hypoparathyroidism akki
Hypoparathyroidism is a condition caused by low levels of parathyroid hormone, which regulates calcium and phosphorus levels in the body. This leads to low calcium and high phosphorus in the blood. Symptoms include numbness, muscle cramps, and tetany. It can be congenital if the parathyroid glands do not develop properly prenatally. Treatment focuses on calcium and vitamin D supplementation to raise calcium levels and prevent symptoms. Long term management may involve hormone replacement or a special diet.
Pheochromocytoma
Pheochromocytoma is a rare tumor that develops on the adrenal glands or nearby abdominal tissues. It causes the overproduction of hormones like epinephrine and norepinephrine. Pheochromocytomas can be benign or malignant. They most commonly affect humans in adulthood but can occur in dogs over 7 years old as well. Symptoms include high blood pressure, headaches, sweating, and abdominal or chest pain. Diagnosis involves tests like CT scans, MRI scans, urine/blood tests and biopsies. Treatment is usually surgical removal followed by medication to control hormone levels, with about a 10% recurrence rate.
Pheochromocytoma and its anaesthetic management
This document discusses pheochromocytoma, including its epidemiology, clinical presentation, diagnosis, and management. Key points include: Pheochromocytomas are rare neuroendocrine tumors that secrete excess catecholamines. Common symptoms include headaches, sweating, palpitations, and hypertension. Diagnosis involves biochemical testing of urine or plasma catecholamines/metabolites and imaging such as CT, MRI, or MIBG scan. Preoperative management focuses on alpha- and beta-blockade to control blood pressure and symptoms prior to surgical resection.
More Related Content
What's hot
Pheochromocytoma
Pheochromocytoma is a rare neuroendocrine tumor that originates in the chromaffin cells of the adrenal medulla. It secretes high amounts of catecholamines, mostly norepinephrine and epinephrine, which can cause symptoms like headaches, sweating, elevated blood pressure and heart rate. Up to 25% of pheochromocytomas are familial and associated with genetic mutations. While signs and symptoms vary, the most common presentation is headaches, sweating and increased heart rate. Diagnosis involves measuring catecholamines in blood or urine samples and imaging tests, while treatment is usually surgical removal of the tumor along with preoperative medication to control blood pressure.
Pediatric pheochromocytoma
This document provides information on pediatric pheochromocytoma including:
- Pheochromocytoma is a rare catecholamine-secreting tumor that arises from chromaffin cells and can cause hypertension.
- Diagnosis involves measuring plasma and urinary metanephrines and imaging studies to locate the tumor(s).
- Treatment requires preoperative medical management to control blood pressure followed by surgical resection, which usually cures the condition.
Pheochromocytoma
Pheochromocytoma is a catecholamine-producing tumor that arises from chromaffin cells of the sympathetic nervous system. It occurs in about 0.1-0.2% of hypertensive patients and can cause paroxysmal or sustained hypertension. Diagnosis involves measuring catecholamines or metanephrines in plasma or urine, which are elevated in most patients. Localization is typically done with CT or MRI imaging. Treatment involves pre-operative alpha-blockade to prevent hypertensive crises during tumor removal, followed by beta-blockers if needed. Complete surgical removal can cure patients if the tumor is benign.
PHEOCHROMOCYTOMA
Pheochromocytoma is a rare neuroendocrine tumor that originates from chromaffin cells of the adrenal medulla. It secretes high amounts of catecholamines, mostly epinephrine and norepinephrine. Symptoms include hypertension, headache, sweating, anxiety and weight loss. Diagnosis involves measuring catecholamines in blood and urine samples. Imaging tests like CT, MRI, MIBG scan and PET are also used. Preoperative treatment includes alpha-blockers to lower blood pressure. Surgical removal of the tumor is the primary treatment. Postoperative care focuses on blood pressure monitoring and managing stress.
Hypertensive encephalopathy
The hypertensive encephalopathy is a syndrome consisting of a sudden elevation of arterial pressure usually preceded by severe headache and followed by convulsions, coma or a variety of transitory cerebral phenomena.
Pheochromocytoma
1) A 15-year-old female presented with headaches, palpitations, and increased sweating. Imaging found a 5.7 cm mass in her right adrenal gland.
2) Biopsy of the removed mass confirmed pheochromocytoma. Pheochromocytomas are rare tumors that produce catecholamines, causing high blood pressure.
3) She was given alpha-blockers preoperatively to lower her blood pressure. A right adrenalectomy was performed to remove the tumor, and she required blood transfusions and medications post-surgery to manage her blood pressure before being discharged.
Hypopituitarism
This document provides an overview of hypopituitarism, including its anatomy, etiology, clinical features, diagnosis, and treatment. Hypopituitarism is a clinical syndrome of deficiency in pituitary hormone production and secretion that can result from disorders of the pituitary gland, hypothalamus, or surrounding structures. Common causes include tumors, trauma, infections, infiltrative disorders, and genetic mutations. Clinical features vary depending on which hormones are deficient but may include fatigue, weight changes, dry skin, and visual disturbances. Diagnosis involves hormonal blood tests and dynamic testing. Treatment is lifelong hormone replacement therapy to mimic normal hormone levels.
Prolactinoma
Prolactinomas are the most common pituitary tumors, accounting for 35-48% of cases. They cause hyperprolactinemia and symptoms like amenorrhea, galactorrhea, and infertility. Diagnosis involves hormonal tests, MRI of the pituitary, and visual field tests. Treatment options include dopamine agonists like cabergoline as first-line therapy. Surgery via transsphenoidal resection is also used and has low risks but high remission rates, especially for microadenomas. Radiation is reserved for larger residual or recurrent tumors.
Thyrotoxicosis, hyperthyroidism
Graves' disease is the most common cause of thyrotoxicosis, accounting for 60-80% of cases. It is an autoimmune disorder causing hyperthyroidism due to thyroid stimulating immunoglobulins that activate the TSH receptor. Symptoms include anxiety, heat intolerance, palpitations, weight loss and goiter. Treatment involves antithyroid medications, radioactive iodine therapy or surgery to control the hyperthyroidism. Radioactive iodine is often the preferred treatment option. Graves' disease can also cause eye changes and pretibial myxedema. Managing the condition during pregnancy requires careful titration of antithyroid medications.
Upper Gastrointestinal bleeding
This document provides an overview of acute gastrointestinal bleeding. It defines upper gastrointestinal bleeding and discusses its causes, including variceal and non-variceal sources. Signs and symptoms are outlined. The approach involves taking a thorough history and physical exam. Key lab tests include CBC, LFTs, coagulation panels and endoscopy. Treatment depends on the bleeding source, and may include endoscopic methods, radiological embolization, surgery, or medications like PPIs and vasoactive drugs. Complications are also reviewed.
Adrenal insufficiency
The adrenal glands secrete hormones that regulate metabolism, electrolyte balance, and stress response. The medulla secretes epinephrine and norepinephrine, while the cortex secretes steroids such as cortisol and aldosterone. Cortisol secretion follows a diurnal rhythm controlled by the HPA axis. Primary adrenal insufficiency results from failure of the adrenal glands, while secondary is a failure of the HPA axis. Presentation includes fatigue, weight loss, hypotension, and hyperpigmentation. Diagnosis involves short corticotropin stimulation tests. Treatment is with glucocorticoid replacement such as hydrocortisone.
Prolactinoma
This document outlines prolactinomas, which are the most common functional pituitary adenomas. It discusses the epidemiology, clinical manifestations, diagnosis, and treatment of prolactinomas. Prolactinomas are most frequently diagnosed in women between ages 20-50 and are caused by a prolactin-secreting tumor in the pituitary gland. Diagnosis involves assessing clinical symptoms, serum prolactin levels, and MRI imaging of the pituitary. Medical treatment with dopamine agonists is the primary treatment, with cabergoline being the first-line therapy due to its effectiveness and safety. Surgery and radiation are reserved for cases where medical treatment is ineffective or for large macroadenomas.
Hepatorenal syndrome
Hepato Renal Syndrome (HRS) is a form of kidney failure that occurs in patients with advanced chronic liver disease. It results from intense renal vasoconstriction caused by interactions between the systemic and portal circulatory systems. HRS has no underlying kidney pathology and typically develops spontaneously or in response to precipitating events like infections, bleeding, or large volume paracentesis. Diagnosis is based on criteria and HRS carries the worst prognosis of all liver disease complications. Treatment involves terlipressin and liver transplantation provides a definitive cure.
Hepatic Encephalopathy -Pathophysiology,Evaluation And Management
Hepatic encephalopathy is a brain dysfunction caused by liver disease or portosystemic shunting. It presents as a wide range of neurological or psychiatric abnormalities from mild alterations to coma. The prevalence is 30-40% in those with cirrhosis and risk of first episode is 5-25% within 5 years of cirrhosis diagnosis. Recurrence risk after an initial episode is 40% within 1 year. Ammonia, systemic inflammation, manganese, genetics, and oxidative stress may all contribute to pathogenesis. Diagnosis involves clinical exam and testing like serum ammonia levels or neuropsychological tests on phone apps. Management involves treating precipitating factors, lactulose, antibiotics like rifaximin, and
Cushing syndrome
This document discusses Cushing's syndrome, which results from high cortisol levels in the blood. It can be caused by exogenous glucocorticoid use, pituitary tumors, adrenal tumors, or ectopic ACTH-secreting tumors. Signs include central obesity, thin skin, high blood pressure, and bone weakness. Diagnosis involves screening tests like dexamethasone suppression tests and measuring ACTH and cortisol levels. If endogenous, further tests localize the source and guide treatment like surgery, radiation, or medication. The most common causes and their treatment approaches are summarized.
Addison disease by dr shahjada selim
- A 40-year-old patient presented with low-grade fever, coughing up blood, and weight loss. Tests showed signs of tuberculosis (TB) and the patient was started on anti-TB drugs. However, the patient died suddenly after 3 days of treatment.
- Addison's disease is a condition caused by insufficient production of hormones by the adrenal glands. It was first described by Dr. Thomas Addison in the 19th century. Common causes include autoimmune disease and TB infection of the adrenal glands.
- Without treatment, Addison's disease can cause low blood pressure, low blood sugar, high potassium levels, and even death. Treatment involves replacing glucocorticoid and
HYPERTENSION EMERGENCY & URGENCY
1. The document discusses hypertensive emergencies and urgencies, their causes, manifestations, evaluation, and management.
2. Initial evaluation involves assessing for target organ damage by examining cardiovascular, neurological, and renal systems. Laboratory tests and imaging help identify secondary causes and end-organ effects.
3. Intravenous antihypertensives like sodium nitroprusside, nicardipine, and labetalol are used to lower blood pressure in hypertensive emergencies to prevent further organ damage, while oral medications are preferred for urgencies.
renal tubular acidosis (RTA)
metabolic acidosis develops because of defects in the ability of the renal tubules to perform the normal functions required to maintain acid-base balance.
Interesting case presentation - PHEOCHROMOCYTOMA
Dr. P. Salamon Rajap G
Presented two interesting cases of Pheochromocytoma and discussed the importance of proper preoperative preparation to decrease morbidity and mortality for these types of tumors.
PPT on Hypoparathyroidism akki
Hypoparathyroidism is a condition caused by low levels of parathyroid hormone, which regulates calcium and phosphorus levels in the body. This leads to low calcium and high phosphorus in the blood. Symptoms include numbness, muscle cramps, and tetany. It can be congenital if the parathyroid glands do not develop properly prenatally. Treatment focuses on calcium and vitamin D supplementation to raise calcium levels and prevent symptoms. Long term management may involve hormone replacement or a special diet.
What's hot (20)
Hepatic Encephalopathy -Pathophysiology,Evaluation And Management
Hepatic Encephalopathy -Pathophysiology,Evaluation And Management
Viewers also liked
Pheochromocytoma
Pheochromocytoma is a rare tumor that develops on the adrenal glands or nearby abdominal tissues. It causes the overproduction of hormones like epinephrine and norepinephrine. Pheochromocytomas can be benign or malignant. They most commonly affect humans in adulthood but can occur in dogs over 7 years old as well. Symptoms include high blood pressure, headaches, sweating, and abdominal or chest pain. Diagnosis involves tests like CT scans, MRI scans, urine/blood tests and biopsies. Treatment is usually surgical removal followed by medication to control hormone levels, with about a 10% recurrence rate.
Pheochromocytoma and its anaesthetic management
This document discusses pheochromocytoma, including its epidemiology, clinical presentation, diagnosis, and management. Key points include: Pheochromocytomas are rare neuroendocrine tumors that secrete excess catecholamines. Common symptoms include headaches, sweating, palpitations, and hypertension. Diagnosis involves biochemical testing of urine or plasma catecholamines/metabolites and imaging such as CT, MRI, or MIBG scan. Preoperative management focuses on alpha- and beta-blockade to control blood pressure and symptoms prior to surgical resection.
Pheochromocytoma
This document discusses the case of a 36-year-old woman presenting with intermittent high blood pressure, sweating, and panic attacks who is suspected of having pheochromocytoma. For initial treatment, alpha blockade with phenoxybenzamine is recommended for at least 1-3 weeks before surgery to prevent hypertensive crisis during the operation. Laparoscopic surgery is preferred for smaller tumors, while larger tumors typically require open surgery. Following successful removal of the tumor, most patients become normotensive, though some may remain hypertensive and require further treatment and monitoring.
Pheo_Ahmed_Younes (2)
1. A 32-year-old man presented with severe chest pain and fluctuating blood pressure and died from heart failure. Autopsy revealed a large pheochromocytoma and no heart disease.
2. Pheochromocytomas are rare catecholamine-producing tumors that can cause dangerous hypertension, heart failure, and death if not properly diagnosed and treated.
3. Diagnosis involves testing plasma or urine for metanephrines and imaging like CT or MRI to locate the tumor. Treatment is surgical removal of the tumor.
Pathology of the Adrenal Gland
This document summarizes the pathology of the adrenal gland. It describes the normal histology and physiology and discusses hyperplasia and neoplasia that can occur in the cortex and medulla. Hyperplasias include subcapsular and cortical hyperplasia. Neoplasms include subcapsular adenomas and carcinomas, cortical adenomas and carcinomas, and various types of pheochromocytomas such as benign, malignant, and complex pheochromocytomas. Neuroblastomas and ganglioneuromas are also mentioned. The document provides examples of photomicrographs to illustrate many of these conditions.
Iodine lecture jan2014
This document summarizes progress made in eliminating iodine deficiency through universal salt iodization programs globally and in Central and Eastern Europe and Central Asia specifically. It finds that:
1) Nearly all countries achieved over 90% household coverage of iodized salt by 2009, up from less than half in 2000, largely eliminating iodine deficiency disorders.
2) Successful country programs enacted strong regulations mandating adequate iodine levels in all food-grade salt and had oversight to manage progress, while less successful programs focused only on household salt or had weak standards.
3) Studies show correction of even mild iodine deficiency through salt iodization programs improved cognitive test scores and school performance in children.
Phaeochromocytoma
Phaeochromocytoma is a rare catecholamine-producing tumor that is a treatable cause of hypertension. It occurs in less than 1% of hypertensive patients. Ninety percent arise in the adrenal medulla and are usually benign and unilateral. Symptoms include episodic hypertension, chest tightness, restlessness, anxiety, pallor, and weakness. Diagnosis involves screening for metadrenalines or catecholamines in a 24-hour urine collection. Treatment involves careful blood pressure control prior to surgery using alpha-blockers like phenoxybenzamine, followed by beta-blockers like propranolol. Complete removal of the tumor cures the condition.
Hyerparathyroidism
This document summarizes parathyroid gland anatomy and physiology and various types of hyperparathyroidism. It discusses the role of parathyroid hormone in calcium homeostasis, causes of primary, secondary, and tertiary hyperparathyroidism, associated symptoms and complications, diagnostic testing, treatment options including medication and surgery, and other related conditions like familial benign hypercalcemia and hypercalcemia of malignancy.
Feb 2015 journal watch with links
This document is the February 2015 issue of the UTSW Internal Medicine Journal Watch. It contains summaries of recent articles across various specialties, including endocrinology, rheumatology, health care improvement, general internal medicine, nephrology, infectious diseases, hepatology, and cardiology. There is also an EKG challenge case. The endocrinology section highlights updates to diabetes screening and treatment guidelines from the American Diabetes Association, including changes to blood glucose and blood pressure targets. The health care improvement section discusses a study finding that some health plans are using adverse drug tiering to discourage enrollment by patients with high-cost conditions like HIV.
Anaesthetic management of pheochromocytoma
This document discusses the management of patients undergoing surgery to remove pheochromocytomas. It covers pre-operative assessment, intraoperative principles, monitoring, anesthesia techniques, and postoperative care. Some key points:
- Open surgery is quicker but laparoscopic allows for longer tumor handling.
- Pre-op evaluation includes checking blood pressure control, end organ damage, and renal/cardiac function.
- Intraop management requires a team approach and careful hemodynamic control using antihypertensives, vasodilators, and adrenergic blockers.
- Post-op patients need monitoring for rebound hypertension from tumor removal or hypotension from adrenal suppression. Blood sugar also needs monitoring
Back ground for the prsentation.
The document discusses various endocrine causes of secondary hypertension, including pheochromocytoma, primary hyperaldosteronism, and Cushing's syndrome. Pheochromocytomas are rare tumors that produce catecholamines and can cause paroxysmal hypertension, headaches, sweating, and palpitations. Primary hyperaldosteronism is often caused by an aldosterone-producing adenoma or bilateral adrenal hyperplasia, and results in hypertension and hypokalemia. Cushing's syndrome is characterized by hypercortisolism and causes central obesity, hypertension, glucose intolerance, and other symptoms. Diagnosis of endocrine causes involves biochemical and imaging tests.
CT of Pheochromocytoma: Findings in Symptomatic & Incidentally Discovered Tumors
CT of Pheochromocytoma: Findings in Symptomatic & Incidentally Discovered TumorsGaspar Alberto Motta Ramírez
This study analyzed CT scans of 33 pheochromocytoma tumors to determine if there were differences between incidentally discovered and symptomatic tumors. The results showed that 42% of tumors were incidentally discovered without symptoms. No significant differences were found between the two groups in terms of patient age, gender, tumor size, location, or enhancement levels. However, symptomatic tumors were more likely to have calcification and a history of hypertension. Incidentally discovered tumors had higher necrosis scores on average but the difference was not statistically significant. The study concluded that CT findings cannot be used to differentiate between incidental and symptomatic pheochromocytoma tumors.Hyperparathyroidism
There are two main types of hyperparathyroidism, primary hyperparathyroidism and secondary hyperparathyroidism. Learn more about the differences.
The impact of maternal and fetal thyroid hormone deficiency: iodine deficienc...
Thyroid hormone deficiency at critical periods of brain development may cause permanent mental and neurological disability and impairment. Iodine deficiency is the commonest preventable cause of mental disability
Surgical management of pheochromocytoma
This document discusses the surgical management of pheochromocytoma. It covers various surgical approaches including open adrenalectomy, flank retroperitoneal approach, transabdominal chevron approach, thoracoabdominal approach, and laparoscopic adrenalectomy. For each approach, it describes the patient positioning, incision details, dissection techniques, and closure. It also lists some operative complications and notes hypotension can occur after tumor removal in pheochromocytoma cases due to alpha blockade.
Iodine deficiency disorder and metabolic syndrome
Iodine deficiency can cause goiter and impaired brain development. Symptoms include enlargement of the thyroid gland, neurological deficits, and delayed sexual maturation. It is assessed by palpation, ultrasound, and urinary iodine levels. Daily iodine requirements range from 50 μg for infants to 150 μg for those over 12 years old. The metabolic syndrome is defined as abdominal obesity plus two other risk factors and increases the risk of cardiovascular disease and diabetes. It involves central obesity, high triglycerides, low HDL, high blood pressure, and elevated fasting glucose. Lifestyle modifications including diet, exercise, and weight loss are first-line treatment approaches.
Iodine Presentation
Iodine is a non-metallic, violet colored halogen element with an atomic number of 53. It was discovered in 1811 in France by Bernard Courtois and gets its name from the Greek word "Iodes." Iodine naturally occurs in brines, Chilean nitrate deposits, and is found in trace amounts in the universe, sun, meteorites, crustal rocks, sea water, fresh water, and humans. Its main uses are in medicine, disinfectants, photography, and salt.
Viewers also liked (17)
CT of Pheochromocytoma: Findings in Symptomatic & Incidentally Discovered Tumors
CT of Pheochromocytoma: Findings in Symptomatic & Incidentally Discovered Tumors
The impact of maternal and fetal thyroid hormone deficiency: iodine deficienc...
The impact of maternal and fetal thyroid hormone deficiency: iodine deficienc...
Similar to Pheochromocytoma
pheomcrmycytoma.pptx
This document discusses pheochromocytoma, a rare catecholamine-secreting tumor that arises from chromaffin cells of the adrenal medulla. It notes that pheochromocytomas have an annual incidence of approximately 0.8 per 100,000 people. Symptoms can include paroxysmal or primary hypertension, headaches, sweating, and tachycardia. Diagnosis involves biochemical testing for catecholamines and metanephrines in urine or plasma. Treatment consists of preoperative medical management with alpha- and beta-blockers to control blood pressure, followed by surgical adrenalectomy.
Adrenal Gland Tumours and their Management
The document discusses adrenal gland tumors and their management. It begins with the anatomy and physiology of the adrenal glands and outlines the classification of adrenal tumors. It then discusses specific tumor types like adrenocortical adenoma, adrenocortical carcinoma, pheochromocytoma, neuroblastoma, and ganglioneuroma. For each tumor, it covers clinical features, diagnosis, and management strategies including surgery, medication, and follow up. Surgical resection is the primary treatment for most benign functioning and non-functioning tumors, while malignant tumors may also require chemotherapy or radiation.
MEN SYNDROMESAND GENETIC BASIS.pptx
This document discusses a case of multiple endocrine neoplasia type 1 (MEN1) in a 46-year-old female patient and her brother. The patient presented with symptoms of hypoglycemia and was found to have hyperparathyroidism, a pituitary adenoma, and insulinomas. Genetic testing confirmed a MEN1 gene mutation. Her brother also had features of MEN1 including acromegaly, hyperparathyroidism, and insulinomas. MEN1 is a rare genetic disorder characterized by tumors of the parathyroid glands, anterior pituitary, and pancreatic islet cells. Early detection of MEN1-associated tumors through genetic screening and biochemical monitoring of at-risk family members
Pheochromocytoma dr ashish nair
This document discusses the anesthetic management of patients with pheochromocytoma. It begins by covering the physiology and pathophysiology of catecholamine-producing tumors. It then discusses the clinical presentation of pheochromocytoma, including signs, symptoms, diagnosis, and management - with a focus on preoperative preparation and management. Key aspects of preoperative preparation include controlling blood pressure through alpha and beta blockade, fluid administration, and reversing metabolic disturbances, in order to optimize patient hemodynamics and safety during tumor resection.
Paraneoplastic Endocrine Syndrome
Paraneoplastic syndromes occur in 7-15% of malignancies and involve substances secreted by tumors affecting distant sites. Common syndromes include endocrine disorders like Cushing syndrome from ACTH/cortisol overproduction. Hypercalcemia, the most frequent paraneoplastic syndrome, results from PTHrP secretion by cancers like breast and lung. Other syndromes involve inappropriate antidiuretic hormone or insulin secretion. These syndromes provide clues to underlying malignancies, impact prognosis, and challenge management. Recognition of tumor-induced hormonal imbalances is important for timely cancer diagnosis and treatment.
Lecture 9. adrenal medulla diseases
1. Pheochromocytomas are rare tumors that originate from chromaffin cells in the adrenal medulla or extra-adrenal paraganglia. They secrete catecholamines and can cause hypertension.
2. Neuroblastoma is a common malignant tumor in children under 5 years old that originates from embryonic nerve cells, often in the adrenal medulla or chest. It commonly metastasizes and presents with abdominal issues or carcinoid syndrome.
3. Ganglioneuroma is a rare, benign tumor of the sympathetic nervous system in adults that produces symptoms due to its size and location. It is diagnosed using imaging and urine tests. Surgery is usually sufficient treatment.
Prolactinoma
This case involves a 22-year-old woman presenting with galactorrhea and amenorrhea. Her prolactin level was elevated at 144 ng/mL. MRI showed a 5mm microadenoma in her right pituitary gland. She was prescribed cabergoline to lower her prolactin levels, with plans to follow up in 2-3 months. The document then provides background information on pituitary adenomas including causes, classifications, clinical presentations, investigations and management options such as surgery, medication and radiotherapy. The main treatment discussed is dopamine agonists as first-line therapy for prolactinomas.
Adrenal Neoplasia and MEN Syndrome
Seminar presentation by group C 5th year medical student under supervision Dato Imi, endocrine specialist in HRPZ II.
Reference as mentioned at the end of the slide presentation
Pheo presentation 3 2 18
Pheochromocytoma is a rare tumor of the adrenal medulla that secretes excess catecholamines. It was first described in 1886 and successful surgical treatment was reported in 1926. It typically presents with headaches, sweating, and palpitations. Biochemical testing of urine or plasma is used to diagnose, and imaging such as CT, MRI, or MIBG scans are used to localize the tumor. Preoperative management focuses on alpha-blockade to prevent hypertension during tumor manipulation. Surgery is usually curative though long term monitoring is needed due to risk of recurrence.
Mell phaeochromocytoma physio
This document discusses phaeochromocytoma, a rare neuroendocrine tumor that secretes catecholamines. It notes that 80% occur in the adrenal medulla and 20% in sympathetic ganglia. Clinical features include paroxysmal or sustained hypertension as well as symptoms from catecholamine surges. Diagnosis involves measuring catecholamines and their metabolites in a 24-hour urine collection. Imaging scans can then locate the tumor. Treatment is surgical removal along with pre-operative use of alpha-blockers to prevent dangerous blood pressure drops from catecholamine withdrawal.
Phaeochromocytoma a case
it is a young boy ,suddenly became unconscious, found high blood pressure on clinical exam,. on USG bilateral adrenal mass confirmed on contrast CT scan. Radiological diagnosis was made phaeochromocytoma
Surgically correctable hypertension
This document provides information on pheochromocytoma, including:
1) It describes the history, epidemiology, clinical features, differential diagnosis, and "10% tumor rule" characteristics.
2) Biochemical testing using urine or plasma tests for metanephrines is described as the primary diagnostic method. Localization uses CT, MRI, or MIBG scans.
3) Extensive pre, intra, and postoperative management is outlined to prevent hemodynamic instability, including alpha-blockade, IV fluids, and monitoring. The goal of treatment is surgical removal which is often curative.
Adrenal tumor, classification, management - easy explanation
Adrenal tumor- topic for B.Sc Nursing Students, GNM Students
definition
classification
clinical manifestations
treatment
easy explanation for nursing students
jing2020.pdf
A 28-year-old woman was found to have a rare dopamine-secreting pheochromocytoma in her left adrenal gland. She presented with abdominal pain but was otherwise asymptomatic. Testing found significantly elevated dopamine levels in her serum and urine. Preoperative treatment with an alpha-blocker caused hypotension and palpitations. Surgery was performed and she experienced major blood pressure fluctuations, eventually stabilizing after vasopressor therapy. Histopathology and genetic testing confirmed a dopamine-secreting pheochromocytoma without mutations. These tumors are harder to diagnose due to vague symptoms and have a higher risk of malignancy than other pheochromocytoma types.
benign and malginant conditions of the adrenal gland-2.pptx
The adrenal gland is one of the most important endocrine glands in the body and any lesion in it could result into serious complications
PHEOCHROMOCYTOMA.pptx
Midazolam
Moderator: Yes, midazolam is preferred for premedication as it provides anxiolysis and sedation without significant cardiovascular or respiratory depression. Other options include oral clonazepam the night before.
The key goals of preoperative management are:
1. Adequate alpha blockade to prevent hypertensive crisis during tumor manipulation. This is achieved using phenoxybenzamine or doxazosin.
2. Beta blockade to prevent reflex tachycardia during surgery. Propranolol is commonly used.
3. Optimization of fluid status and control of blood pressure using additional agents like calcium channel blockers if needed.
4. Thorough preoperative
Multiple myeloma . dr umair afzal
Multiple Myeloma, pathogenesis and treatment, according to latest nccn guidelines.
being shared only for educational purposes
Adrenal glands hegazy
The adrenal glands are composed of an outer cortex and inner medulla that arise from different embryonic layers. Phaeochromocytomas are rare catecholamine-secreting tumors that originate in the adrenal medulla. Diagnosis involves measuring urinary or plasma metanephrines and imaging tests. Treatment requires preoperative alpha-blockade to prevent dangerous blood pressure fluctuations during tumor resection surgery. Lifelong follow-up is needed due to the risk of recurrence or metastasis.
Adrenal glands hegazy
The adrenal glands are composed of an outer cortex and inner medulla that arise from different embryonic layers. Phaeochromocytomas are rare catecholamine-secreting tumors that originate in the adrenal medulla. Diagnosis involves measuring urinary or plasma metanephrines and imaging tests. Treatment requires preoperative alpha-blockade to prevent dangerous blood pressure fluctuations during tumor resection surgery. Lifelong follow-up is needed due to the risk of recurrence or metastasis.
adrenal gland part 1.pptx
This document provides an overview of adrenal gland anatomy, physiology, and the management of several adrenal gland disorders. It discusses Conn's syndrome (primary hyperaldosteronism), Cushing's syndrome, sex hormone excess from adrenal tumors, and pheochromocytoma. For each condition, it describes the epidemiology, clinical presentation, diagnostic approach including localization tests, and surgical and medical management strategies. It provides case examples and details perioperative care for adrenal surgery. The overall document is a lecture on adrenal gland disorders and their clinical approach and treatment.
Similar to Pheochromocytoma (20)
Adrenal tumor, classification, management - easy explanation
Adrenal tumor, classification, management - easy explanation
benign and malginant conditions of the adrenal gland-2.pptx
benign and malginant conditions of the adrenal gland-2.pptx
More from HAMAD DHUHAYR
Kawasaki disease
This document discusses Kawasaki disease, a condition that causes inflammation of medium-sized arteries. It begins with a case study of a 2-year-old boy exhibiting symptoms including fever, rash, and swollen lymph nodes who was later diagnosed. It then summarizes vasculitis and describes Kawasaki disease in more detail, noting it often affects the coronary arteries and children under 5. While the specific cause is unknown, it is thought to involve an immune response triggered by various factors in genetically susceptible individuals. The document outlines treatment and notes that with early treatment, recovery is expected though risks of coronary complications remain if untreated.
Approch to cough in children
This document provides an overview of the approach to cough in children. It begins with background on cough and the cough reflex pathway. It then discusses classifications of cough based on duration, quality, and etiology. The document outlines the important components of history taking and physical examination for a child with cough. It recommends investigations such as chest X-ray, pulmonary function tests, and bronchoscopy if needed. The document concludes with guidelines for managing cough in children based on its underlying cause.
Typical antipsychotic
This document discusses antipsychotic medications. It covers their general concepts and mechanism of action as D2 receptor antagonists. It lists their indications for treating schizophrenia, psychosis, and movement disorders. Side effects include extrapyramidal symptoms and tardive dyskinesia from long-term dopamine blockade. Specific medications discussed include chlorpromazine, haloperidol, and long-acting injections. First-generation antipsychotics are also called typical antipsychotics and work by reducing dopaminergic neurotransmission through D2 receptor antagonism.
Personality disorder - cluster C
This document discusses three Cluster C personality disorders: avoidant personality disorder, dependent personality disorder, and obsessive-compulsive personality disorder. Cluster C disorders are characterized by anxious and fearful thinking and include social inhibition, feelings of inadequacy, a need to be taken care of by others, and preoccupation with perfectionism and control. The document provides information on prevalence, sex ratios, common comorbidities, family occurrences, typical treatments including psychotherapy and medication, and physician-patient interactions for each disorder.
Amniotic fluid disorder
This document discusses amniotic fluid disorders including polyhydramnios and oligohydramnios. It defines polyhydramnios as excessive amniotic fluid over 2 liters and oligohydramnios as diminished fluid under 500 ml. Causes, diagnosis, and complications are described for each condition. Polyhydramnios can be caused by fetal abnormalities or diabetes and risks preterm labor and cord problems. Oligohydramnios risks pulmonary hypoplasia and deformities from compression and is often caused by renal issues. Management may include treating underlying issues, monitoring fetal wellbeing, and amnioinfusion.
liver abscess
This document provides information on liver abscesses, including their classification, etiology, pathophysiology, diagnosis, and management. It discusses pyogenic and amoebic liver abscesses. Pyogenic abscesses are usually polymicrobial and result from bacterial infection spreading to the liver via the bloodstream or adjacent organs. Amoebic abscesses are caused by Entamoeba histolytica infection and spread from the intestines to the liver via the portal vein. Key diagnostic tests include ultrasound, CT scan, and serology. Pyogenic abscesses are typically treated with antibiotics and drainage of larger abscesses, while amoebic abscesses often resolve with antiamoebic medications alone. Prompt diagnosis and treatment are
nerve injury
This document discusses nerve injuries, including their classification, pathophysiology, rehabilitation, diagnosis, and treatment. It defines nerve injuries as interruptions of normal nerve physiology that affect nerve conduction. Nerve injuries are classified into degrees ranging from neurapraxia, which involves demyelination without axonal injury, to neurotmesis, which is a complete nerve division. The document outlines the various types of nerve injuries, their clinical presentations, and rehabilitation approaches, which may involve splinting, stimulation, and physical therapy over months to years. Surgical techniques for repair include primary repair, grafting, transfers, and conduits.
Hirdschsprug disease
Hirschsprung disease is a disorder where part or all of the large intestine lacks nerves and cannot function properly. This causes severe constipation or abdominal distension in infants. It occurs when neural crest cells fail to migrate during development. Diagnosis involves abdominal x-rays, barium enema, rectal biopsies and manometry. Treatment is surgical removal of the affected portion of intestine. The most common procedures are Swenson, Duhamel and Soave operations, which have mortality rates of 1-6% and risks of complications like leakage or enterocolitis.
Postoperative fever -hamad
This document discusses postoperative fever, including its definition, pathophysiology, and causes. Fever is a common inflammatory response after surgery due to cytokine release from tissue trauma. Within 24 hours of surgery, 27-58% of patients may develop a fever from non-infectious causes. Infectious causes of postoperative fever include pneumonia, urinary tract infections, wound infections, deep vein thrombosis, and drug reactions. A thorough physical exam and diagnostic tests can help identify the cause, and treatment depends on the underlying condition, such as draining an abscess, treating a urinary tract infection with antibiotics, or providing anticoagulation for deep vein thrombosis.
Ulner nerve
This document summarizes injuries to the ulnar nerve at different locations. It describes the motor and sensory functions of the ulnar nerve and the effects of injuries to the ulnar nerve at the elbow or wrist. An injury to the ulnar nerve at the elbow can cause paralysis of hand muscles and clawing of the ring and little fingers. Sensory loss from an elbow injury affects the medial hand and 1.5 fingers. A wrist injury causes similar but less severe effects. Treatment options described include nerve stimulation, splinting, exploration and repair of any defects in the nerve.
Retention of urine
Retention of urine occurs when one is unable to completely empty the bladder. It can be acute, occurring suddenly due to obstruction, or chronic, developing over time. Acute retention requires immediate catheterization to drain the bladder, while chronic retention involves identifying and treating the underlying cause of the partial obstruction. A thorough history, exam, and testing is needed to determine if the retention is due to issues in the bladder, prostate, urethra, or other causes and select the appropriate management.
Parathyroid
The parathyroid glands regulate calcium levels in the blood and bones. There are usually four parathyroid glands located near the thyroid gland. The parathyroid glands secrete parathyroid hormone (PTH) which increases blood calcium levels when low by promoting bone resorption and renal reabsorption of calcium. Primary hyperparathyroidism occurs when one parathyroid gland enlarges and overproduces PTH, commonly caused by a benign tumor in the gland. Surgical removal of the enlarged gland is usually curative for primary hyperparathyroidism.
Esophagial carcinoma
The esophagus is a muscular tube that transports food from the pharynx to the stomach. Esophageal cancer most often occurs in the lower third of the esophagus. Risk factors include chronic irritation from smoking, alcohol, and hot foods. Symptoms include difficulty swallowing and weight loss. Diagnosis involves endoscopy with biopsy. Treatment depends on the stage but may include surgery, radiation, intubation or bypass for inoperable tumors. The prognosis remains poor due to late diagnosis but endoscopic screening of high risk patients such as those with Barrett's esophagus can detect early cancers with a better outlook.
Atropine
Atropine is a naturally occurring alkaloid extracted from deadly nightshade, Jimson weed, and mandrake. It has a wide variety of medical uses including as a cycloplegic and mydriatic in ophthalmology to dilate the pupils. It is also used to treat bradycardia and various types of heart block by increasing the heart rate. Additionally, atropine inhibits secretions and acts as a bronchodilator. It is used to treat organophosphate and nerve agent poisoning by blocking acetylcholine receptors. Common side effects include vision changes, dry mouth, fast heart rate, and confusion. Atropine is contraindicated in conditions like glaucoma and myast
Lower back pain
A 14-year-old Saudi male presented to the emergency room with low back pain localized to the sacroiliac region for 12 hours after falling from his bike. On examination, he was in no distress and had no neurological abnormalities, injuries, or bruising. X-rays showed no abnormalities. He was diagnosed with a ligamentous strain or muscle strain and treated conservatively with rest, NSAIDs, and muscle relaxants. He was discharged once his pain was controlled and he could ambulate.
SCC
This document discusses squamous cell carcinoma (SCC), a malignant skin tumor. It defines SCC as a cancer originating from keratinizing cells of the epidermis. The document then covers the epidemiology, pathology, spread/complications, clinical presentation, differential diagnosis, investigation, treatment, and prognosis of SCC. Key points include that SCC is the second most common skin cancer, affects sun-exposed skin of elderly males, and has varying malignancy depending on factors like depth of invasion and histological grade.
Upper git bleeding
A 53-year-old woman presented with abdominal pain and vomiting blood. Her symptoms indicated upper gastrointestinal bleeding. The most common causes of upper GI bleeding are esophageal varices, acute gastric erosions caused by NSAIDs, acute hemorrhagic gastritis, and chronic duodenal ulcers. Initial management involves resuscitation through intravenous fluids and blood transfusions. Endoscopy is important to localize the source of bleeding and allow for potential treatment. The endoscopy may reveal varices, ulcers, or erosions as the cause. Angiography can help diagnose bleeding from rare sources if endoscopy is inconclusive.
Hsv,ebs,cmv and hzv
This document summarizes several herpesviruses that can cause infections in humans, including HSV, HZV, CMV, and EBV. HSV can cause oral and genital sores and remains latent in nerves. HZV, which causes shingles, results from reactivation of the varicella zoster virus. CMV is transmitted through bodily fluids and can cause severe disease in immunocompromised individuals. EBV commonly causes infectious mononucleosis and has been linked to some cancers.
ABG
This document provides normal ranges for arterial blood gas (ABG) values including pH, partial pressure of carbon dioxide (Paco2), partial pressure of oxygen (Pao2), oxygen saturation (Sao2), and bicarbonate (HCO3). It also defines the anion gap formula as sodium minus chloride plus bicarbonate, states the normal anion gap is 12 mmol/L, and notes hyperchloremia can cause changes in the anion gap.
Thyrotoxicosis in pregnancy - hamad
This document discusses thyrotoxicosis (hyperthyroidism) during pregnancy. It notes the physiological changes in thyroid function during pregnancy, including increases in thyroid binding globulin and decreases in plasma iodide levels. It describes the signs and symptoms of maternal hyperthyroidism as well as its most common cause, Graves' disease. Guidelines are provided for clinical management, including use of thionamide medications like propylthiouracil to control thyroid levels while monitoring the fetus. Treatment may also include beta blockers, iodine, or subtotal thyroidectomy in rare cases. Radioactive iodine therapy is contraindicated in pregnancy due to risks to the fetal thyroid.
More from HAMAD DHUHAYR (20)
Recently uploaded
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by Stamler, Verified Chapters 1 - 33, Complete Newest Version Community Health Nursing A Canadian Perspective, 5th Edition by Stamler, Verified Chapters 1 - 33, Complete Newest Version Community Health Nursing A Canadian Perspective, 5th Edition by Stamler Community Health Nursing A Canadian Perspective, 5th Edition TEST BANK by Stamler Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Pdf Chapters Download Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Pdf Download Stuvia Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Study Guide Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Ebook Download Stuvia Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Questions and Answers Quizlet Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Studocu Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Quizlet Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Pdf Chapters Download Community Health Nursing A Canadian Perspective, 5th Edition Pdf Download Course Hero Community Health Nursing A Canadian Perspective, 5th Edition Answers Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Ebook Download Course hero Community Health Nursing A Canadian Perspective, 5th Edition Questions and Answers Community Health Nursing A Canadian Perspective, 5th Edition Studocu Community Health Nursing A Canadian Perspective, 5th Edition Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Pdf Chapters Download Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Pdf Download Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Study Guide Questions and Answers Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Ebook Download Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Questions Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Studocu Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Stuvia
Efficacy of Avartana Sneha in Ayurveda
Avartana Sneha is a unique method of Preparation of Sneha Kalpana in Ayurveda, mainly it is indicated for the Vataja rogas.
Artificial Intelligence Symposium (THAIS)
Artificial Intelligence Symposium (THAIS). Parc Taulí. Sabadell
Does Over-Masturbation Contribute to Chronic Prostatitis.pptx
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
The Best Ayurvedic Antacid Tablets in India
Treat the symptoms of indigestion, heartburn and stomach reflux with the 10 Best Ayurvedic Antacid Tablets in India.
share - Lions, tigers, AI and health misinformation, oh my!.pptx
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Kat...
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Kat...rightmanforbloodline
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.REGULATION FOR COMBINATION PRODUCTS AND MEDICAL DEVICES.pptx
It includes regulation of combination products and medical devices. FDA and industry liaisons.
Hemodialysis: Chapter 4, Dialysate Circuit - Dr.Gawad
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
The Electrocardiogram - Physiologic Principles
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Ketone bodies and metabolism-biochemistry
This slide consists of all the topics of ketone . This can be used for exam purpose for writing about Diabetic keto acidosis etc . Thank you
Recently uploaded (20)
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...
Does Over-Masturbation Contribute to Chronic Prostatitis.pptx
Does Over-Masturbation Contribute to Chronic Prostatitis.pptx
share - Lions, tigers, AI and health misinformation, oh my!.pptx
share - Lions, tigers, AI and health misinformation, oh my!.pptx
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Kat...
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Kat...
REGULATION FOR COMBINATION PRODUCTS AND MEDICAL DEVICES.pptx
REGULATION FOR COMBINATION PRODUCTS AND MEDICAL DEVICES.pptx
Vestibulocochlear Nerve by Dr. Rabia Inam Gandapore.pptx
Vestibulocochlear Nerve by Dr. Rabia Inam Gandapore.pptx
Hemodialysis: Chapter 4, Dialysate Circuit - Dr.Gawad
Hemodialysis: Chapter 4, Dialysate Circuit - Dr.Gawad
Ear and its clinical correlations By Dr. Rabia Inam Gandapore.pptx
Ear and its clinical correlations By Dr. Rabia Inam Gandapore.pptx
Pheochromocytoma
- 1. PHEOCHROMOCYTO MA Hamad Emad H. Dhuhayr
- 2. CONTENTS • SOEPEL • PHEOCHROMOCYTOMA • REFFERENCES
- 3. SOEPEL S A 35-year-old husband and father of three children, has been experiencing headaches and palpitations of increasing frequency and severity over the past six months. In addition, he has had periods of intense anxiety and panic attacks. • O taking history and physical examination. • E Anxiety disorders, hyperthyroidism and pheonchomocytoma • P Echo and ecg • E medication. • L pheonchomocytoma
- 5. DEFINITION • Catecholamine-secreting tumors that arise from chromaffin cells of theAdrenal medulla and the sympathetic ganglia are referred to as pheochromocytomas And extra-adrenal catecholamine-secreting paragangliomas, respectively. • Because the tumors have similar clinical presentations and are treated With similar approaches, many clinicians use the term pheochromocytoma to Refer to both entities. • However, the distinction between pheochromocytoma And paraganglioma is an important one because there are differences in the Risk for associated neoplasms, risk for malignant transformation, and type of Genetic testing that should be considered. • Rare but treatable.
- 8. PATHOLOGY • Tumor of chromaffin tissue. • 90% from adrenal medulla & 10% from other chromaffin tissue from the carotid down to Urinary bladder. • 90% benign and 10% malignant • 90% is unilateral • 10% multiple tumors.
- 10. COMPLICATION 1. CNS: stoke secondary to hypertension 2. CVS: ischaemic heart disease (coronary spasm + HTN), cardiomyopathy (catecholamines Induced myo-necrossis+ hypertension) 3. DM: due to insulin antagonism. 4. sudden death due to arrhythmia
- 11. ASSOCIATIONS • Neurofibromatosis • MEN-ii • Hypertrophic cardiomyopathy • Von-hipple lindeau “VHL” syndrome: CNS and retinal hemangioblstomas, renal and pancreatic cysts, and hypernephroma. • Sturge weber syndrome: CNS a-v malformation, and cutanouse angioma of the face.
- 12. INVESTIGATIONS 1- hormone function: - ECG, ECHO, and blood glucose level. - suppressor test: clonidine injection iv 5mg → ↓ of BP by 53/25 mmhg for 15 minutes Due to blockade of alpha-receptors in other forms of hypertension but not in Pheochromocytoma. 2- hormone level: - serum catecholamines level is elevated (n=2-5mg/L) - neurophysin serum level is elevated (secreted in equimolar concentration with epinephrine)
- 13. 3- hormone end product: 24hrs urinary vallinyl mandelic acid (VMA) is elevated (the urine Should be collected in acidic medium and refrigerated). The result of the test is falsely high In patients taking alpha-methyl dopa, banana or pine apple (n=2-6 mg/24 hrs). 4- of cause: - CT, MRI or sonography of abdomen - iodine 131 -metaiodobenzyl guanidine (MIBG) scanning, particularly in extra-abdominal Tumors. - IVP may show indentation of the upper pole of kidney
- 15. TREATMENT • 1- hormone action: α-blocker (phenoxybenzamine 20- 40 mg/day) followed by β-blocker (propranolol 120-240 mg/day) or combined α and β blocker (labetalol) • 2- surgical removal of the tumor.
- 16. FOLLOW UP • The 24-hour urinary excretion of fractionated catecholamines and metanephrinesOr plasma fractionated metanephrines should be checked annually For life. • Annual biochemical testing assesses for metastatic disease, tumor Recurrence in the adrenal bed, or delayed appearance of multiple primaryTumors. • Follow-up CT or MRI is not needed unless the metanephrine or catecholamine Levels become elevated or the original tumor was associated with Minimal or no catecholamine or metanephrine excess.
- 17. REFFERENCES • KUMAR • CEICEL • DAVIDSONE • WEBSITE