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ABD & SMALL PARTS > fortune cookies > Flashcards

fortune cookies Flashcards

1
Q

adrenal relationship to peritoneum

A

retroperitoneal

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2
Q

adrenals lie in which space

A

perinephric space

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3
Q

what are the two structures of the adrenal

A

cortex and medulla

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4
Q

what is the function of the adrenal

A

stress management

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5
Q

what does the cortex control

A

salt
sugar
sex

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6
Q

what does the medulla control

A

adrenalin (epinephrine and norepinephrine)

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7
Q

most masses in the adrenal are __

A

solid and benign

not a ‘cyst maker’

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8
Q

types of solid adrenal cortical masses

A

benign adrenal adenoma
mets
myelolipoma
malignant primary

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9
Q

which adrenal masses are usually bilateral

A

mets

hyperplasia

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10
Q

what are the types of adrenal medullary tumours

A

pheochromocytoma
neuroblastoma

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11
Q

which adrenal tumour associated with MEN syndrome

A

pheochromocytoma

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12
Q

which adrenal tumour is found in infants

A

neuroblastoma

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13
Q

which is more aggressive, neuroblastoma or nephroblastoma

A

neuroblastoma

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14
Q

which adrenal tumour effects fight or flight response

A

pheochromocytoma

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15
Q

what is urinary VMA

A

tumour marker for pheochromocytoma

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16
Q

which primary cancer usually leads to mets to the adrenals

A

lung cancer

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17
Q

which adreanl mass has SOS artifact

A

myelolipoma

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18
Q

if there is a cyst in the adrenal area, what is it likely to be

A

post-traumatic pseudocyst

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19
Q

in normal adrenal, __ is hypoechoic and __ is echogenic

A

cortex = hypo
medulla = hyper

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20
Q

adrenals are __ to the crura

A

anterolateral

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21
Q

which nervous system involves the fight or flight response

A

sympathetic nervous system

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22
Q

what type of gland is adrenal

A

endocrine

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23
Q

what is the hormone that controls salt

A

aldosterone
(mineral corticoids = salt)

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24
Q

what is the hormone that controls sugar

A

coritsol
(gluccocorticoids = sugar)

25
Q

what is the hormone that controls sex

A

androgen and estrogen
(gonadocorticoids = sex)

26
Q

epinephrine aka

A

adrenalin catecholemines

27
Q

medullary hormones are __ transmitters

A

neurotransmitters

28
Q

if there is tumour thrombus in the IVC, the mass is more likely to be __ in origin

A

renal

29
Q

what are the 2 types of cystic adrenal masses

A

adrenal cysts (pseudo)

adrenal hemorrhage (neonates)

30
Q

adrenal adenoma majority are __

A

non functioning

benign

incidental

31
Q

cortical hyperadrenal syndromes

A

Conn’s disease (salt)
Cushing’s syndrome (sugar)
Adrenal Virilism (sex)

32
Q

excessive cortisol syndrome called

A

Cushing’s syndrome

obesity, moonface, HTN, hirsutism, muscle weakness, menstrual disorders, osteoporosis, ‘buffalo hump’

33
Q

causes for Cushing’s

A

pituitary tumour ++ stumuli for cortisol

adrenal tumour (ie adenoma) ++ cortisol

iatrogenic ingestion of cortisol (ie steroids)

34
Q

adrenal adenomas most commonly present with which findings?

A

non functioning, unilateral

hypoechoic, solid

35
Q

common primaries for adrenal mets

A

lung, breast, lymphoma, renal

often bilat

36
Q

what is a myelolipoma made of

A

fat and bone marrow elements

usually asymptomatic (large ones can rupture)

37
Q

sono features of adrenal myelolipoma

A

solid, well defined

hyperechoic, homogeneous

SOS arficact

38
Q

which sono sign points to adrenal rather than renal mass

A

wedge sign

39
Q

hormone activity of adrenal myelolipoma

A

hormonally inactive

most asymptomatic

most managed conservatively (annual checks)

40
Q

features of adrenal carcinoma

A

very rare

large, solid, hypoechoic

may be functional or non functional

look for signs of malignancy
** extension into adrenal vein or IVC
**retroperitoneal adenopathy
**liver mets

41
Q

what makes pheochromocytoma functional

A

secretes catecholamines (epi and norepinephrine)

42
Q

10% of pheochromocytomas are found outside the adrenal medulla, in the extra-adrenal. where is that?

A

organ of Zuckerkandl - sympathetic ganglia or carotid body

43
Q

HTN, headache, palpitations (anxiety) and sweating are symptoms associated with which adrenal tumour

A

pheochromocytoma

44
Q

90% of pheochromocytomas are in adrenal medulla - what is the 10% rule?

A

bilat, malignant, children

45
Q

sono features of pheochromocytoma

A

solid, mixed cystic/solid

vascular lesions (can hemorrhage)

need hx

46
Q

what is diaphoresis

A

sweating

47
Q

MEN II syndrome aka

A

Sipple syndrome

48
Q

what is associated with MEN II sydrome

A

pheochromocytoma
medullary thyroid carcinoma
parathyroid hyperplasia

49
Q

cancer affecting immature or developing nerve cells, most common in babies

A

neuroblastoma

50
Q

neural crest cells are nerve cells, precursor to __ cells

A

chromaffin

51
Q

sono feature of neuroblastoma

A

large, solid

heterogeneous mass

calc and necrosis common
some hemorrhage

52
Q

nephroblastoma aka

A

Wilms’ tumour

a renal malignancy in children
solid, relatively homogeneous in comparison

53
Q

etiology of neonatal adrenal hemorrhage

A

uncertain
- postpartum trauma
- asphyxia
- infection

usually bilateral

54
Q

sono appearance of neonatal adrenal hemorrhage

A

bilat

depends on age of hematoma

typically complex cystic mass

no vascularity

f/u - calc, decreasing size

55
Q

sono features of adrenal hyperplasia

A

usually bilat, normal shape and normal echogenicity

increased size >1.5 cm AP

56
Q

hypoadrenalism aka

A

adrenal insufficiency

  • not an u/s dx
57
Q

what is the most common cause of adrenal insufficiency

A

Addison’s disease

autoimmune low cortisol and aldosterone

58
Q

symptoms of hypoadrenalism

A

non specific

abd pain, weakness, low blood pressure

ABD & SMALL PARTS (16 decks)

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