Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Uroradiology > adrenal gland > Flashcards

adrenal gland Flashcards

1
Q

What are the 3 main categories of adrenal disease?

A

Hyperfunctioning, Adrenal insufficiency, normal functionE

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

What is cushings syndrome? What are the two types? What is the diagnostics test?

A

excess glucocorticoid
Exogenous - large doses of steroid
Endogenous - overproduction of cortisol by adrenal cortex

urniary 17-hydroxycorticosteroid level

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

What is the majority cause of cushings syndrome? What are the types?

A

Excess ACTH

ACTH dependent - bilateral adrenal hyperplasia

ACTH independent - adenoma, carcinoma, PPNAD, AIMAH

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

What are the causes of excess ACTH in ACTH dependent cushings?

A

Pituitary, oat cell tumor, bronchial adenoma, ovary, pancreas, thymus, thyroid

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

Truncal obesity, hirsutism, abdominal striae, and muscle atrophy suggest what syndrome?

A

Cushings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How do you distinguish macronodular hyperplasia from pituitary adenoma versus a cortisol producing adenoma

A

Size of contralateral adrenal gland - will be atrophic in cortisol secreting adenoma and enlarged in pituitary adenoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is conns syndrome? What are the types?

A

Primary aldosteronism

Adrenal hyperplasia - idiopathic hyperaldosteronism (more common), primary adrenal hyperplasia
Adrenal tumor

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

What are the two types of primary aldosteronism hyperplasia subtype? What are the differences in treatment?

A

Idiopathic hyperaldosteronism - medically

Primary adrenal hyperplasia - surgical if unilateral, otherwise medical

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

Hypokalemia, hypertension, increased aldosterone, low renin

A

Conn syndrome

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

What is the pathophysiology of conns syndrome?

A

ALdosterone causes sodium retention which leads to increased plasma volume and hypertension. Potassium is exchanged for sodium in the distal tubule, thus causing hypokalemia

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

How is primary vs secondary hyperaldosteronism determined?

A

Serum renin levels - will be elevated in secondary and low in primary

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

What is the most common form of CAH? What are the symptoms?

A

deficiency of 21-hydroxylase

excess androgen effect

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

What are the two types of adrenal insufficiency?

A

Primary - tissue destruction of adrenal glands

Secondary - inadequate stimulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are 5 causes of primary adrenal insufficiency

A 
Idiopathic
Granulomatous disease
Metastasis - rarely, because so much cortex (>90%) must be destroyed
Lymphoma
Hemorrhage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is a distinguishing characteristic of primary vs secondary adrenal insufficiency?

A

Primary will have destruction of all producing cells and have decreased cortisol, androgen, and aldosterone.

Secondary will have normal aldosterone production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How much of the adrenal gland has to be destroyed before addisons occurs?

A

90%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

why do addisons patients get hyperpigmentation?

A

Because of decreased cortisol production, there will be increased ACTH production which is on the same gene as melanocyte stimulating hormones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the radiographic appearance of addisons?

A

Depends on the cause

Granulomatous disease will be calcified with bilateral enlargement with maintanance of shape

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Which tumors are larger - conns or cushings

A

Cushings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which has larger adrenal glands - exogenous or endogenous?

A

Exogenous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

When is venous sampling helpful?

A

in determining masculinizing/feminizing tumors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are pheochromocytomas composed of? What is the name for an extra-adrenal pheochromocytoma?

A

Chromaffin cells

Paragangliomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is MEN2A and MEN2B

A

2A - PMP, medullary thyroid, pheo, parathyroid

2B - Medullary, pheo, marfan, neuromas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What, aside from MEN, are the associations with pheochromocytoma? What is carney’s triad?

A

NF1, VHL

gastric leiomyosarcoma, pulmonary chondroma, extra adrenal pheochromocytoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Where are most pheos located? What is the difference in location between sporadic and MEN associated pheos?
90% in medulla Sporadic - up to 25% outside adrenal, normal medulla MEN - multicentric and intraadrenal, hyperplastic medulla
26
T or F: extraadrenal pheos are more likely to be malignant
True
27
What is administered prior to removal of pheo?
alpha (phenoxybenzamine) and beta blockers (propranolol)
28
How do pheos enhance? how do they appear on T1/T2?
heterogeneously hypo T1 hyper T2
29
What are the NM scans used for pheochromocytoma?
I131-MIBG or Indium 111 pentetreotide (octreotide) scan PET scans are also useful and can detect tumors that fail to concentrate MIBG
30
Where is the most common site for a neuroblastoma?
Adrenal gland
31
What age range for neuroblastomas?
32
What are neuroblastomas? What is the malignant and benign maturation tumor?
Primitive tumors from sympathetic nervous system tissue Benign - ganglioneuroma, greater degree of cellular maturation Malignant - ganglioneuroblastoma, greater degree of cellular maturation with more mature ganglion cells mixed with neuroblasts
33
What is the radiographic appearance of neuroblastoma?
US - heterogenous echogenicity with poorly defined margins CT - can have calcification on unenhanced study. Large and heterogenous w/wo low density areas of necrosis or hemorrhage. CAN INVADE paraspinal musculature and foramen MRI - hetergenous signal. T1 will be hypo to liver/kidney, T2 will be hyper to liver and iso to kidney
34
Which tumors can invade paraspinal musculature and neural foramina
Neuroblastomas
35
Which tumor has a "dumbbell" appearance? Why?
Neuroblastoma - tumor growth through the foramen with epidural expansion
36
Distinguish posttherapy fibrosis from recurrent neuroblastoma?
Fibrosis is hypo on T2 Recurrence is hyper
37
What are the NM scans useful for neuroblastomas?
Bone scans - due to high rate of bone mets MIBG or Octreoscan
38
What is the makeup of an adrenal adenoma
cords of clear cells separated by fibrovascular trabeculae
39
What percentage of adenoma are lipid poor?
20%
40
How does an adrenal adenoma image on MRI? How is it different/similar to mets?
Low signal on T1 and T2 Low on T2 differentiates between mets (high T2, low T1)
41
With regards to adrenal carcinoma, M or F get functional tumors more?
Female
42
What is the most common functional syndrome with adrenal carcinoma?
Cushings
43
What is the CT appearance of adrenal carcinoma?
Large mass with central hypoattenuation representing necrosis, calcification in 30%
44
What are the important areas to check with adrenal carcinoma regarding extension/mets?
Hepatic or regional lymph node metastasis | Extension into left renal vein or IVC
45
What is needed to confidently rule out hepatic mets in adrenal carcinoma
Fat plane separating tumor and adrenal gland
46
What invasive method can be used to diagnose adrenal origin?
Selective arteriography of the renal, inferior phrenic, celiac, hepatic, or middle adrenal
47
What is the vasculature to adrenal carcinoma?
HYPOvascular, most vascularity is on the periphery which is supplied by the inferior phrenic artery
48
What is the MR imaging of adrenal carcinoma?
heterogenous and hyperintense on T1 and T2 heterogenous enhancement
49
What is a myelolipoma? How does it look on US?
benign tumor of mature adipose cells and hematopoietic tissue Highly echogenic mass with propagation speed artifact (similar to comet tail)
50
What is the main difference between adenoma and myelolipoma?
Adenoma - homogenous lowe density Myelolipoma - heterogenous low density
51
Which side is adrenal hemorrhage more common in? Why?
Right The right adrenal vein enters the IVC directly, which in trauma with the increase in venous pressure, is directly transmitted back to the right adrenal vein
52
What are the associated conditions with adrenal hemorrhage
septicemia, HTN, renal vein thrombosis, tumor, anticoagulation therapy, steroids
53
What age is adrenal hemorrhage most common?
Newborn
54
What is the result of most adrenal hemorrhages?
Resorption a small amount can persist as a pseudocyst
55
What are the types of adrenal cyst? which is most common? M or F prediliction?
Female prediliction Endothelial (most common), lymphangiomatous, epithelial, parasitic, pseudocysts (second most common)
56
Which sex is hemangioma more prominent?
Female prediliction Large mass with thick irregular wall and hypodense ceter
57
What are CT findings suggesting mets over adenoma
``` Size >3cm poorly defined margins invasion of adjacent structures inhomogenous attenuation thick, irregular, enhancing rim ```
58
What is the nuclear medicine scan that is useful in adenoma vs mets
scintigraphy with NP59
59
What is the difference in contrast enhancement between adenoma and mets?
Adenoma washout quicker!
60
What is the equation to determine enhancement washout?
% enhancement washout = enhancement washout / enhancement Enhancement washout = enhanced attenuation value - delayed contrast attenuation value Enhancement = enhanced - unenhanced
61
What is the equation to determine washout if no unenhanced is available
% relative washout = enhancement washout / enhanced attenuation value
62
What are the cutoff percentages to diagnose adenoma?
Regular - if washout >60%, adenoma is confidently diagnosed Relative - if washout >40%, adenoma confidently diagnosed
63
What is the basis of comparison on in and out of phase imaging?
Paraspinal muscles
64
What is the general cutoff on MRI in/out of phase imaging in terms of signal intensity loss?
>20%
65
What is the most common complication in adrenal biopsy? What is the complication in an anterior approach to the left adrenal gland?
Pneumothorax Pancreatitis
66
Which lymphoma is more common in the adrenal glands?
NHL
67
What is the appearance of lymphoma in the adrenal glands?
Homogenous soft tissue mass with enhancement

Uroradiology (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions