Question 15.2

Created on Mon, 05/25/2015 - 23:27
Last updated on Mon, 02/01/2016 - 22:14
Pass rate: 63%
Highest mark: ?

Other SAQs in this paper

Other SAQs on this topic

A 50 year old lady is admitted to the coronary care unit for investigation of resistant hypertension and chest pain. A cardiac arrest call is put out because she drops her blood pressure to 60/30mmHg, upon your arrival she is pale, diaphoretic, tremulous with a pulse of 130 bpm and a BP 300/120mmHg. No medications have been administered to account for the hypertension. A similar episode had occurred the previous day.

a. What diagnosis is likely?

b. List 5 treatment measures for the management of the haemodynamic instability associated with this condition.

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College Answer

a. What diagnosis is likely?
•    Phaeochromocytoma

b. List 5 treatment measures for the management of the haemodynamic instability associated with this condition.
•    Admit to the intensive care unit for invasive monitoring
•    SNP/GTN for HT crisis
•    Alpha Blockade followed by beta blockade,
•    Intravenous magnesium has been shown to have an effective role in this situation
•    Hypotension with fluids / Adrenaline/noradrenaline

Discussion

This question on phaeochromocytoma closely resembles Question 22 from the second paper of 2010. The details of management are discussed there, as well as in the brief summary on phaeochromocytoma in the section on endocrine disorders in the ICU.