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Dr. Dummy then tested his next hypothesis by giving Phelix Atropine ... Phelix had an adverse reaction to Atropine, Dr. Dummy had reason to believe that ... – PowerPoint PPT presentation

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Title: Pheochromocytoma

  • Team Ramrod
  • Elizabeth Bannister
  • Matt Sweeny
  • Kristina Kizer
  • Andy Christensen
  • Peter de Quiina

What is the problem?
  • Phelix, a 22 year old male, is experiencing
    headache, palpitations, excessive sweating and
    weight loss.
  • He is hyperglycemic, hypertensive, and he has
    normal thyroid hormone levels.
  • His symptoms increase under stress.

So why did Dr. Dummy care about the thyroid gland?
  • Phelix is exhibiting symptoms that are very
    common with hyperthyroidism, an excessive
    secretion of T3 and T4.
  • Symptoms include increased metabolism, weight
    loss, palpitations, sweating, and arrhythmias.
  • Dr. Dummy then tested his next hypothesis by
    giving Phelix Atropine
  • A competetive inhibitor at PNS muscarinic
    receptors found in many tissues such as the
    heart, GI tract and blood vessels

What the is the deal with Phelix?
  • Since thyroid hormone levels were normal and
    Phelix had an adverse reaction to Atropine, Dr.
    Dummy had reason to believe that there was a
    different endocrine problem.
  • Pheochromocytoma a tumor in the adrenal medulla
    that results in the excessive secretion of
    epinephrine and norepinephrine

So what is this feokromoesightoma…???
  • The excess release of adrenal hormones puts
    Phelix in an uncontrollable state of fight or
  • Pheochromocytoma is also known as the 10 tumor
    because it kicks in only about 10 of the time.

FIGHT or Flight
  • Activation of the sympathetic nervous system
    releases epinephrine and norepinephrine which
    bind to the adrenergic alpha and beta receptors
    on target tissues.
  • This triggers an increase in heart rate and
    breathing, constriction of blood vessels in many
    parts of the body and/or a tightening of muscles.

  • Epinephrine binds to Alpha1 and Beta2 receptors
    in the liver which elevate the blood sugar level
    by increasing hydrolysis of glycogen to glucose
  • This explains why Phelix has an increased amount
    of glucose in his blood (hyperglycemia).

Weight Loss…Yes!
  • Epinephrine also binds to Alpha2 and Beta2 in
    adipose tissue and stimulates the release of
    fatty acids which causes the breakdown of fat.
  • Phelix is also losing weight because the rest
    and digest functions of the enteric nervous
    system are being suppressed during the
    sympathetic nervous response.
  • Alpha and Beta receptors of the GI smooth muscle
    respond to sympathetic situations by inhibiting
    gut motility.

Where is my Excedrin?
  • The headaches Phelix are experiencing are a
    result of increased blood pressure (hypertension)
    and vasodilatation.
  • Blood vessels in the brain dilate because of the
    fight or flight response and the slow pain
    pathway receptors in blood vessels transmit pain
    signals we can perceive.

How do we know?
  • Possible tests
  • 24 hour urinary analysis for catecholamines
    (epinephrine, norepinephrine, and dopamine)
  • Serum Blood Test for adrenaline by-products

Fix me doc.
  • Temporary treatment-Alpha blockers, such as
    Phenoxybenzamine and beta blockers such as,
    Propranolol and Atenolol, that block the
    receptors for catecholamines.
  • Surgical treatment- minimally invasive
    laparoscopic adrenalectomy.
  • Available in most hospitals in the US

  • Devil sympathetic effects of pheochromocytoma
  • Angel Parasympathetic nervous system