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Endocrinology Adrenal Gland Disorders Intermediate
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Pheochromocytoma Clinical Features

5
P's
OF
PHEO
Classic paroxysmal presentation of catecholamine-secreting chromaffin cell tumors of the adrenal medulla.

Excessive episodic release of epinephrine and norepinephrine stimulates alpha-1, beta-1, and beta-2 adrenergic receptors, producing characteristic paroxysms of sympathetic storm.

Systematic Breakdown

P

Pressure (Severe Hypertension)

Sustained or episodic severe blood pressure spikes; resistant to standard antihypertensive therapy.

P

Pain (Pounding Headache)

Severe, sudden, throbbing headache caused by abrupt cerebral vasoconstriction and surge in blood pressure.

P

Perspiration (Profuse Diaphoresis)

Drenching sweats accompanying hypertensive paroxysms.

P

Palpitations & Tachycardia

Pounding, rapid heartbeat and panic/anxiety sensation due to cardiac beta-1 stimulation.

P

Pallor

Marked facial and peripheral cutaneous vasoconstriction mediated by alpha-1 adrenergic stimulation.

High-Yield Clinical Pearls & Exam Tips
  • Preoperative Rule: ALWAYS initiate ALPHA-blockade (Phenoxybenzamine) BEFORE BETA-blockade! Beta-blockade first leaves alpha-1 receptors unopposed, causing lethal hypertensive crisis.
  • Diagnostic test of choice: 24-hour urine fractionated metanephrines and catecholamines, or plasma free metanephrines.
Related Pharmaceuticals
Phenoxybenzamine Phentolamine Propranolol Metyrosine
Related Clinical Conditions
MEN 2A MEN 2B von Hippel-Lindau Disease Neurofibromatosis Type 1
Authoritative Sources: Harrison's Principles of Internal Medicine 21e · Endocrine Society Pheochromocytoma Guidelines

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Hypercalcemia Symptoms & Signs

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Classic medical rhyme describing systemic manifestations of severe hypercalcemia (serum Ca2+ > 12 mg/dL).

Williams Textbook of Endocrinology 14e 2,453

System Notice

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