Adrenal Gland Pathology

Question 1

Addison disease is also known as (2)

Answer 1

primary adrenocortical insufficiency
chronic primary hypoadrenalism

Question 2

what is Addison disease?

Answer 2

endocrine disorder that results from the hypofunction of the adrenal cortex

Question 3

in Addison disease, the cortex inadequately secretes ___ resulting from partial or complete destruction of the adrenal glands

Answer 3

corticosteroids

Question 4

4 causes of Addison disease

Answer 4

idiopathic
autoimmune disorder
infection
tuberculosis

Question 5

ultrasound appearance of Addison disease (2)

Answer 5

acute = enlarged adrenal glands
chronic = atropic or calcified

Question 6

signs/symptoms of Addison disease (4)

Answer 6

hypotension
weakness/fatigue
weight loss
hyperpigmentation

Question 7

lab values of Addison disease (4)

Answer 7

elevated liver enzymes
hyperkalemia
hyponatremia
elevated ACTH

Question 8

T/F: ultrasound is the modality choice to diagnose Addison disease

Answer 8

FALSE - CT

Question 9

Cushing syndrome results from (2)

Answer 9

anterior pituitary gland tumor or adrenal tumor

Question 10

ultrasound appearance of Cushing

Answer 10

possible identification of an adrenal mass (adrenal adenoma)

Question 11

signs/symptoms of Cushing (8)

Answer 11

obesity
buffalo hump
HTN
moon-shaped face
hirsutism (excessive hair growth in women)
red/purple striae over the ABD and thighs
hyperglycemia
thinning arms & legs

Question 12

Conn syndrome is also known as ____

Answer 12

primary hyperaldosteronism

Question 13

signs/symptoms of Conn syndrome (3)

Answer 13

HTN
excessive thirst & urination
muscle cramps & weakness

Question 14

lab values of Conn syndrome (2)

Answer 14

hypernatremia (increase sodium)
hypokalemia (decrease potassium)

Question 15

what is the most common benign solid mass of the adrenal glands?

Answer 15

adrenal adenoma

Question 16

adrenal adenomas in Cushing’s and Conn syndrome are ____

Answer 16

hyperfunctioning

Question 17

CT or MRI may be needed to differentiate adrenal adenomas from masses arising from ___ or ___

Answer 17

liver or kidneys

Question 18

ultrasound appearance of adrenal adenomas (2)

Answer 18

solid
hypoechoic

Question 19

pheochromocytoma arises from the ___

Answer 19

adrenal medulla

Question 20

what is pheochromocytoma?

Answer 20

hyperfunctioning, benign mass that causes the adrenal gland to release excessive amounts of epinephrine and norepinephrine

Question 21

pheochromocytoma can be ___

Answer 21

malignant

Question 22

ultrasound appearance of pheochromocytoma (3)

Answer 22

large
hyperechoic or hypoechoic
diffusely heterogenous

Question 23

signs/symptoms of pheochromocytoma (6)

Answer 23

uncontrollable HTN
headaches
tachycardia
tremors
anxiety
excessive sweating

Question 24

adrenal cysts are difficult to separate from (3)

Answer 24

liver
spleen
upper pole of the kidneys

Question 25

adrenal cysts with a _____ should be worrisome for malignancy

Answer 25

rim of calcification

Question 26

what are adrenal rests?

Answer 26

accessory adrenal gland tissue

Question 27

adrenal rests are found within the (4)

Answer 27

testes epididymis ovaries inguinal canal

Question 28

adrenal rests are associated with (2)

Answer 28

congenital adrenal hyperplasia Cushings

Question 29

adrenal carcinoma (adenocarcinoma) is ____

Answer 29

rare

Question 30

adrenal glands are the ____ most common site of metastasis

Answer 30

4th most common

Question 31

adrenal metastasis can originate in (6)

Answer 31

lungs breast GI tract thyroid pancreas kidneys

Question 32

adrenal metastasis can originate from (3)

Answer 32

lymphoma leukemia melanoma

Question 33

ultrasound appearance of adrenal carcinoma (2)

Answer 33

solid, hypoechoic large, heterogenous

Question 34

adrenal carcinoma signs and symptoms mimic those of ___

Answer 34

Cushings

Question 35

what is the most common extracranial solid, malignant tumor in children?

Answer 35

neuroblastoma

Question 36

neuroblastomas arise from the ___

Answer 36

adrenal medulla

Question 37

neuroblastomas typically present before age ____

Answer 37

5 years old

Question 38

neuroblastoma median age of diagnosis is ___

Answer 38

22 months

Question 39

ultrasound appearance of neuroblastoma (3)

Answer 39

large, heterogenous mass of calcification hemorrhage metastasis

Question 40

signs/symptoms of neuroblastoma (3)

Answer 40

palpable abdominal mass ABD pain bone pain

Question 41

what is adrenal hemorrhage a result of?

Answer 41

spontaneous hemorrhage in neonates after a traumatic birth or perinatal anoxia

Question 42

ultrasound appearance of adrenal hemorrhage (4)

Answer 42

round or triangular acute = echogenic over time = heterogenous, hypoechoic, and possibly cystic residual calcifications following resolution of hemorrhage

Question 43

most common neonatal adrenal mass

Answer 43

adrenal hemorrhage