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Discussion Starter · #1 · (Edited)
If you face a case where the patient is presented with elevated blood pressure and a mass in the adrenal seen in CT scan or MRI then you have two options:

  1. Pheochromocytoma
  2. Primary hyperaldosteronism
The differentiation is relatively easy:
In Pheochromocytoma you have elevated catecholamines with its consequent increased urinary VMA and cortisol and the crises of tachycardia, sweating, irritability ...etc
In Conn's syndrome you have the effects of high aldosterone such as hypokalemia and alkalosis.

While surgical treatment is similar for both of them with resection of the tumor or adrenalectomy, medical treatment is certainly different.
In pheo you give alpha and beta blockers while in conn you give aldosterone antagonists such as sprinolactone or amiloride.

See also this related thread
http://www.usmle-forums.com/usmle-s...ne-adenoma-idiopathic-hyperaldosteronism.html
 

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hello

thanks for your useful post,with your permission adding that we can prescribe in pheochromocytoma drugs of:

alpha blocker such as phentolamine,
also can give alpha and beta blocker such as labetalol,
but never can give exclusively beta blocker because of elevating alpha adrenergic effects
 

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little more

If you face a case where the patient is presented with elevated blood pressure and a mass in the adrenal seen in CT scan or MRI then you have two options:

  1. Pheochromocytoma
  2. Primary hyperaldosteronism
The differentiation is relatively easy:
In Pheochromocytoma you have elevated catecholamines with its consequent increased urinary VMA and cortisol and the crises of tachycardia, sweating, irritability ...etc
In Conn's syndrome you have the effects of high aldosterone such as hypokalemia and alkalosis.

While surgical treatment is similar for both of them with resection of the tumor or adrenalectomy, medical treatment is certainly different.
In pheo you give alpha and beta blockers while in conn you give aldosterone antagonists such as sprinolactone or amiloride.

See also this related thread
http://www.usmle-forums.com/usmle-s...ne-adenoma-idiopathic-hyperaldosteronism.html
let me add more tips:
-pheochromocytoma-episodic htn...but hyperald is chronic one
-ttt of pheochrom, emphasize on give FIRST alpha block before beta block...i feel more convenient than saying give both..i know u meant same...
 
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