Adrenal disease Flashcards
1
Q
signs that mass may be adrenal carcinoma vs. benign
A
- look at char. on CT
- large is worse esp over 6cm
- growing?
- hyperfunction?
2
Q
4 types of adrenal hyper
A
- pheo- epi
- cushings - gluco
- hyperaldosteronism - mineralocorticoids
- sex hormoes
3
Q
2 times to go to surgery
A
- secreting hormones
2. Large and with features of malignancy
4
Q
when to biopsy mass
A
NEVER before ruling our pheo
- can dump epi
- if ruled out, can biopsy
5
Q
classic triad of pheo
A
Pain (headache)
Perspiratiokn
Palpitations
6
Q
how to test for pheo
A
24hr urine
- metanepherines, catecholamine
- creatiinien - to make sure you get a good measure
7
Q
what to test for cuchings
A
- make sure it’s not exogenous
2. dexamethasone supression test
8
Q
presentation of hyperaldosteron
A
hypertensions +/- hypokalemia
9
Q
what is seen on test for hyperaldo
A
high aldo and low renin
10
Q
3 possible causes for unsupressed cortisol
A
- high ACTH (pit, ectopic ACTH or CRH)
- ACTH indep. ( adernal cort.)
- exogenous - glucocort drug
11
Q
3 steps for adrenal cushings
A
- diagnose (urine cortisol and supression test)
- look for cause of cushings
- imagining (CT/MRI)
12
Q
role of pathol in adrenal (3)
A
- define lesion
- do patho findings explain clinical findings
- prognostics
13
Q
basic classification of adrenal lesion in adults
A
Cortex - adrenal cortical hyperplasia - AC adenoma - AC carcinoma Medulla - Adrenal meduallary hyperplasia - pheo
14
Q
gross patho of a adrenal cortical hypoerplasia
A
- usually bilateral
- diffusely enlarged gland
- can show nodularity
15
Q
what is functional approach
A
for each hormonal syndrome there is a different group of pathological entities
