Which symptom is most characteristic of pheochromocytoma and would be expected to be present preoperatively?

• A. Orthostatic hypotension
• B. Hypertension
• C. Hypoglycemia
• D. Hypokalemia

Answer: (B)

Pheochromocytoma causes excess catecholamine release, leading to vasoconstriction and increased cardiac output that produce hypertension. Because these tumors typically cause elevated blood pressure (often episodic but clinically prominent), hypertension is the symptom you’d expect to be present preoperatively. This is also why preoperative management focuses on alpha-adrenergic blockade to control BP and prevent a hypertensive crisis during tumor manipulation.

Orthostatic hypotension would imply low BP or volume depletion, which isn’t the hallmark of pheochromocytoma. Catecholamines more commonly cause hyperglycemia through glycogenolysis, not hypoglycemia, so that option isn’t typical preoperatively. Hypokalemia isn’t a characteristic feature of pheochromocytoma either.