Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

F3 E4 Shea > Adrenal 2 > Flashcards

Adrenal 2 Flashcards

1
Q

What is primary hyperaldosteronism?

A

Excess production of aldosterone by the adrenal glands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the 2 causes of primary hyperaldosteronism?

A
  1. Adrenal cortical hyperplasia (idiopathic)- MC
  2. Adrenocortical adenoma–> Conn’s syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What should you think if you have a young adult who has HTN but does not have any risk factors or FHx

A

Primary hyperaldosteronism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

CPx of what?

  • HTN (young adult or resistant HTN)
  • HA
  • blurred vision
  • mm. weakness
  • paresthesias
  • polydipsia/polyuria
  • *won’t present with dehydration*
A

Primary hyperaldosteronism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How do oyu diagnose Primary hyperaldosteronism? (5)

A
  1. CMP: hypokalemia, hypernatremia
  2. Incr. plasma/urine aldosterone
  3. Decreased plasma renin
  4. **Saline infusion test- Plasma aldosterone level >10
  5. CT adrenals to eval for adrenal adenoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How do you tx primary hyperaldosteronism?

A
  1. Surgical removal of adenoma
  2. Medical: Spironolactone and antihypertensives
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

a Pheochromocytoma arises from what cells?

A

Chromaffin cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Are PHEOs usually malignant?

A

NO

10% malignant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Pheochromocytomas are associated with what 2 genetic syndromes

A

MEN2

Neurofibromatosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

CPx of what:

  • Paroxysmal attacks lasting 30-40min
  • Paroxysmal palpitations (tachycardia), HA and episodic sweating
A

Pheochromocytoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Sxs of pheochromocytomas are often precipitated by what

A

displacement of abdominal cavity (sitting, bending, deep palpation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Pheochromocytomas are sometimes a/w which cardiomyopathy

A

stress induced (takutsubo) cardiomyopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How do you dx a pheochromocytoma?

A
  • 1st line screening= Metanephrrine in 24hr urine
  • Clonidine suppression test (Pheo: catecholamine levels dont decr)
  • CT abd
  • MIBG scintigraphy (identify extra-adrenal tumors)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How do you tx a pheochromocytoma?

A

surgical resection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What 2 meds do you give prior to surgical resection of pheochromocytoma?

A
  • Alpha-adrenergic blocker (phenoxybenzamine)- titrated until BP and sxs controlled
  • Beta blocker (Propanolol)- overcome tachycardia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is an adrenal incidentaloma?

A

mass >1cm found incidentally

17
Q

There is an increased prevalence of adrenal incidentalomas in which 3 patient populations

A

obese, hypertensives, DM patients

18
Q

are most adrenal incidentalomas functional or non-functional?

A

non-functional

19
Q

What are 6 characteristics of a BENIGN adrenal incidentaloma seen on MRI?

A

**If don’t see the following–> REFER**

  1. Homogenous
  2. Unilateral
  3. Diameter <4cm
  4. LIpid rich (attenuation <10Hu)
  5. Rapid contrast washout
  6. Isointensity compared to liver on T1 and T2 (should be same color as liver
20
Q

How do you determine if an adrenal incidentaloma is hyperfunctioning? (what tests should be ordered if there are sxs of cushings? If you suspect a pheo?)

A
  • Plasma cortisol, serum ACTH, serum DHEA, plasma aldosterone
  • sxs of cushings?
    • Yes- 24 hr urine cortisol
    • No- Dexamethasone suppression test
  • Suspicion for pheo?
    • 24hr urine for metanephrines, catecholamines
21
Q

When is a fine needle aspiration/bx of an adrenal incidentaloma contraindicated ? (2)

A
  1. Biochem evidence of pheo
  2. Known widespread mets
22
Q

How do you tx an adrenal incidentaloma if it is benign in appearance?

(if > 2cm? < 2cm?)

A
  • >2 cm= resection
  • < 2cm= repeat imaging @6mo
  • repeat dexamethasone suppression test annual x4 yrs
23
Q

Which condition do you use the saline infusion test for?

A

Primary hyperaldosteronism

24
Q

Which condition do you use the clonidine suppression test to test for?

A

pheochromocytoma

25
Q

Wha tis the Dexamethasone Suppresion test used for?

A

Test for Hypercortisolism (Cushings syndrome)

26
Q

What is the ACTH stimulation test for?

A

Adrenal insufficiency

27
Q

What 2 conditions does a Plasma ACTH level test for?

A
  1. Adrenal insufficiency
  2. Hypercortisolism

F3 E4 Shea (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions