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medschul
Would pheo have a normal resting BP though?
+16
meningitis
I was trying to justify these tricky questions but very true medschul.. It shouldn't have normal resting BP. Sometimes it seems these NBME always have a trick up their sleeve. Im getting paranoid lol
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nala_ula
The reason why the patient probably has normal HTN is because Pheochromocytoma has symptoms that occurs in "spells" - they come and go. Apparently in that moment, when the physician is examining her, she doesn't have the HTN, but like @meningitis explained, so many adrenergic hormones around leads to double the vasoconstriction when the patient stands up.
+10
meningitis
Thank you @nala_ula for your contribution! Really filled in the gap Iwas missing.
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nala_ula
No problem! Thank you for all your contributions throughout this page!
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mjmejora
I thought the pheochromocytoma was getting squeezed during sitting and releasing the epinephrine then. kinda like how it can happen during manipulation during surgery. Got it right for sorta wrong reasons then oh well.
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llamastep1
When she sits in the examination table there would be a normal activation of the sympathetic system from the stress of getting examined which is amplified by the pheo. Cheers.
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sammyj98
UpToDate: Approximately one-half have paroxysmal hypertension; most of the rest have either primary hypertension (formerly called "essential" hypertension) or normal blood pressure.
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notyasupreme
Damn llama, that is WAYYY too much of an inference. Maybe if they said she was nervous in general or something, but not everyone gets stressed out by a doctor hahaha
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jakelong377
Itโs not about being stressed infront of doctor. When u stand sympathetics activate to prevent orthostatic hypotension, to counter it adrenal medulla released catecholamines so much so that pheochromocytoma patients would appears with flushed skin n such
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Definitely got this question wrong but at the end of the day: I like turtles ๐ข
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notyasupreme
I thought from the 5 Ps of pheochromocytoma, Pallor was one of them? That's what threw me off from keeping it the same.. Or atleast the anking deck says pallor.
+1
saqeer
the way i understand it the pallor is because of the sever vasoconstriction during an episode of catcholamine release but in general anything leading to polycythemia can lead to flushing
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submitted by โmeningitis(644)
When standing up, the body normally activates sympathetic system to avoid orthostatic hypotension.
But since there is now an additive effect of the pheochromocytoma adrenergics, it will lead to a hypertension
(i.e: Double vasoconstriction = Pheo adrenergics + Sympathetic system)