A 19 years old female is seen in the emergency department with symptoms of severe periodic headaches, sweating, nausea & vomiting….her blood pressure is on presentation is 230/130, with heart rate of 92. On standing the patient has BP of 200/100, with a heart rate of 130. On ophthalmologic exam she has mild blurring of optic disc without hemorrhage. The examination is otherwise normal. SO NOW
what is ur Dx?

Headache, sweating, nausea and vomiting with a very high blood pressure in a periodic manner conforms with Pheochromocytoma although about 60% patients with pheochromocytoma have persistent hypertension but even those suffer from crises and exacerbations.

The postural drop in blood pressure is due to blunted sympathetic reflexes or due to dminished plasma volume caused by the profuse sweating and vomiting.

I would appreciate it if someone can elaborate on the fundoscopic exam.

Cheers.

I think it's pheochromocytoma...

thx for the cases&keep up refreshing our mind..

yes...u r right...its pheochromocytoma...
i really enjoy the medical discussions...hope all the friends will participate even if they dont sure of their Dx..
the medicine is amatter of possibility..
thanx 4 u ... Dr.Sara....Dr.Samer

hi dear,

thanks for ur nice sharing...as i see all the finding can be explained by the elevated catecholamines level but i couldn't explain the ophthalmologic finding!!

can u tell how did this happened?

thanks..

u can find the answer inside mohamed taib brain...
really miss u ahmed