Question

Which of the following is false about pheochromocytoma?

• A. Propranolol is preferred drug for hypertension control
• B. Surgery is treatment of choice
• C. VMA are diagnostic test
• D. Catecholamines are diagnostic test

Hint:

In pheochromocytoma, using a beta-blocker alone without prior alpha blockade leads to a dangerous paradoxical rise in blood pressure.

Answer 1

The Correct Option is A

Step 1: Recall the key facts about pheochromocytoma management.
Pheochromocytoma is a catecholamine-secreting tumour of the adrenal medulla. It causes paroxysmal or sustained hypertension due to excessive secretion of epinephrine and norepinephrine.

Step 2: Analyse each option.

• Option A - Propranolol as preferred drug for hypertension: This is FALSE. Propranolol is a non-selective beta-blocker. Using beta-blockers alone in pheochromocytoma is dangerous because blocking beta-2 mediated vasodilation while leaving alpha-1 receptors unopposed leads to paradoxical worsening of hypertension. The preferred drug for pre-operative hypertension control in pheochromocytoma is Phenoxybenzamine (a non-selective alpha blocker), given first before any beta-blocker.
• Option B - Surgery is treatment of choice: TRUE. Surgical excision (adrenalectomy) is the definitive treatment.
• Option C - VMA (Vanillylmandelic acid) are diagnostic: TRUE. Urinary VMA, metanephrines, and catecholamines are the biochemical tests for diagnosis.
• Option D - Catecholamines are diagnostic test: TRUE. Plasma free metanephrines and urinary catecholamines are used for diagnosis.

Conclusion: Propranolol (beta-blocker alone) is NOT the preferred drug; phenoxybenzamine (alpha blocker) is used first.