Sample interview questions: How do you approach the treatment of patients with pheochromocytoma in children?
Sample answer:
Approach to Pheochromocytoma Treatment in Children:
1. Diagnosis and Localization:
- Establish a definitive diagnosis through clinical presentation, biochemical evidence (plasma metanephrines, catecholamines, and imaging studies.
- Localize the tumor using imaging techniques (CT/MRI with iodine-based contrast, MIBG scintigraphy, PET/CT).
2. Preoperative Management:
- Control hypertension with alpha-blockers (e.g., phenoxybenzamine, doxazosin) before surgery. This is crucial to prevent hypertensive crises during surgery.
- Prepare the patient with volume expansion and antihypertensives to minimize the risk of hypotension.
3. Surgical Management:
- Resect the tumor laparoscopically or open surgery.
- Avoid intraoperative manipulation and excessive electrocautery to prevent catecholamine release.
- Ensure complete macroscopic resection, as incomplete resection may lead to recurrence.
4. Postoperative Management:
- Monitor for residual hypertension and hypotension.
- Continue alpha-blockade therapy for several months to prevent d… Read full answer
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