adrenal tumors Flashcards
is adrenal cancer more often hormonally active or not hormonally active?
60% hormonally active
hirsutism, acne, hypokalemia, HTN, fatigue, cancer
hormonally active adrenal cancer
tx for adrenal cancer
surgery if smaller
how to do surgery on tumors under 6 cm?
laparoscopically
most common cause of cushing syndrome
long term steroid use
2nd most common cause of cushing syndrome
pituitary overproducing ACTH
1st step of dx’ing cushings
check cortisol via urine or blood
if positive cortisol test, next step in dx of cushings?
check ACTH
if high cortisol, and ACTH is low, then cause of cushings?
adrenal
if high cortisol, and ACTH is high or normal, then cause of cushings?
ectopic or pituitary source
best method of imaging adrenals
CT scan
tx of cushings with adrenal source
surgery + steroids in perioperative period
necessary to dx and tx____before any other surgery
pheochromocytoma
sweating, HA, tachycardia, nervous attackes, hyperthryoid patients
pheochromocytoma
10% rule used for?
pheochromocytoma
10% ___lateral, 10%___(malignant or benign); 10% ___in/outside adrenal; 10% _____(multiple/single); 10%____(familial/sporadic)
10% bilateral; 10% malignant; 10% extra-adrenal; 10% multiple; 10% familial; 10% children
T or F: clinical sx of pheochromocytoma correlate with size of it
FALSE
assc’d conditions with pheochromocytoma (4)
- NF
- von hippel lindau disease
- tuberous sclerosis
- Men 2a & 2b
to dx pheochromocytoma, can run a plasma _______, or a urine _____
plasma metanephrine; urine catacholamines/metanephrines
best imaging modality for pheochromocytoma
CT
pre-op prep for pheochromocytoma: give ____, followed by _____ if persistent tachycardia
- alpha blocker - phenyoxybenzamine
2. beta blocker
in pheochromocytoma, what must you control early?
adrenal vein
failure to suppress aldosterone secretion by intravascular volume expansion
primary hyperaldosteronism
what is one of the more more common causes of secondary HTN?
Conn’s syndrome
