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Question 1

adrenal relationship to peritoneum

Answer 1

retroperitoneal

Question 2

adrenals lie in which space

Answer 2

perinephric space

Question 3

what are the two structures of the adrenal

Answer 3

cortex and medulla

Question 4

what is the function of the adrenal

Answer 4

stress management

Question 5

what does the cortex control

Answer 5

salt
sugar
sex

Question 6

what does the medulla control

Answer 6

adrenalin (epinephrine and norepinephrine)

Question 7

most masses in the adrenal are __

Answer 7

solid and benign

not a ‘cyst maker’

Question 8

types of solid adrenal cortical masses

Answer 8

benign adrenal adenoma
mets
myelolipoma
malignant primary

Question 9

which adrenal masses are usually bilateral

Answer 9

mets

hyperplasia

Question 10

what are the types of adrenal medullary tumours

Answer 10

pheochromocytoma
neuroblastoma

Question 11

which adrenal tumour associated with MEN syndrome

Answer 11

pheochromocytoma

Question 12

which adrenal tumour is found in infants

Answer 12

neuroblastoma

Question 13

which is more aggressive, neuroblastoma or nephroblastoma

Answer 13

neuroblastoma

Question 14

which adrenal tumour effects fight or flight response

Answer 14

pheochromocytoma

Question 15

what is urinary VMA

Answer 15

tumour marker for pheochromocytoma

Question 16

which primary cancer usually leads to mets to the adrenals

Answer 16

lung cancer

Question 17

which adreanl mass has SOS artifact

Answer 17

myelolipoma

Question 18

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

Answer 18

post-traumatic pseudocyst

Question 19

in normal adrenal, __ is hypoechoic and __ is echogenic

Answer 19

cortex = hypo
medulla = hyper

Question 20

adrenals are __ to the crura

Answer 20

anterolateral

Question 21

which nervous system involves the fight or flight response

Answer 21

sympathetic nervous system

Question 22

what type of gland is adrenal

Answer 22

endocrine

Question 23

what is the hormone that controls salt

Answer 23

aldosterone
(mineral corticoids = salt)

Question 24

what is the hormone that controls sugar

Answer 24

coritsol
(gluccocorticoids = sugar)

Question 25

what is the hormone that controls sex

Answer 25

androgen and estrogen (gonadocorticoids = sex)

Question 26

epinephrine aka

Answer 26

adrenalin catecholemines

Question 27

medullary hormones are __ transmitters

Answer 27

neurotransmitters

Question 28

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

Answer 28

renal

Question 29

what are the 2 types of cystic adrenal masses

Answer 29

adrenal cysts (pseudo) adrenal hemorrhage (neonates)

Question 30

adrenal adenoma majority are __

Answer 30

non functioning benign incidental

Question 31

cortical hyperadrenal syndromes

Answer 31

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

Question 32

excessive cortisol syndrome called

Answer 32

Cushing's syndrome obesity, moonface, HTN, hirsutism, muscle weakness, menstrual disorders, osteoporosis, 'buffalo hump'

Question 33

causes for Cushing's

Answer 33

pituitary tumour ++ stumuli for cortisol adrenal tumour (ie adenoma) ++ cortisol iatrogenic ingestion of cortisol (ie steroids)

Question 34

adrenal adenomas most commonly present with which findings?

Answer 34

non functioning, unilateral hypoechoic, solid

Question 35

common primaries for adrenal mets

Answer 35

lung, breast, lymphoma, renal often bilat

Question 36

what is a myelolipoma made of

Answer 36

fat and bone marrow elements usually asymptomatic (large ones can rupture)

Question 37

sono features of adrenal myelolipoma

Answer 37

solid, well defined hyperechoic, homogeneous SOS arficact

Question 38

which sono sign points to adrenal rather than renal mass

Answer 38

wedge sign

Question 39

hormone activity of adrenal myelolipoma

Answer 39

hormonally inactive most asymptomatic most managed conservatively (annual checks)

Question 40

features of adrenal carcinoma

Answer 40

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

Question 41

what makes pheochromocytoma functional

Answer 41

secretes catecholamines (epi and norepinephrine)

Question 42

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

Answer 42

organ of Zuckerkandl - sympathetic ganglia or carotid body

Question 43

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

Answer 43

pheochromocytoma

Question 44

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

Answer 44

bilat, malignant, children

Question 45

sono features of pheochromocytoma

Answer 45

solid, mixed cystic/solid vascular lesions (can hemorrhage) need hx

Question 46

what is diaphoresis

Answer 46

sweating

Question 47

MEN II syndrome aka

Answer 47

Sipple syndrome

Question 48

what is associated with MEN II sydrome

Answer 48

pheochromocytoma medullary thyroid carcinoma parathyroid hyperplasia

Question 49

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

Answer 49

neuroblastoma

Question 50

neural crest cells are nerve cells, precursor to __ cells

Answer 50

chromaffin

Question 51

sono feature of neuroblastoma

Answer 51

large, solid heterogeneous mass calc and necrosis common some hemorrhage

Question 52

nephroblastoma aka

Answer 52

Wilms' tumour a renal malignancy in children solid, relatively homogeneous in comparison

Question 53

etiology of neonatal adrenal hemorrhage

Answer 53

uncertain - postpartum trauma - asphyxia - infection usually bilateral

Question 54

sono appearance of neonatal adrenal hemorrhage

Answer 54

bilat depends on age of hematoma typically complex cystic mass no vascularity f/u - calc, decreasing size

Question 55

sono features of adrenal hyperplasia

Answer 55

usually bilat, normal shape and normal echogenicity increased size >1.5 cm AP

Question 56

hypoadrenalism aka

Answer 56

adrenal insufficiency * not an u/s dx

Question 57

what is the most common cause of adrenal insufficiency

Answer 57

Addison's disease autoimmune low cortisol and aldosterone

Question 58

symptoms of hypoadrenalism

Answer 58

non specific abd pain, weakness, low blood pressure