Adrenals Flashcards
Choose the most appropriate answer from the list.
- Pituitary dependent Cushing’s disease
- Adrenal tumour causing Cushing’s syndrome
- Ectopic ACTH causing Cushing’s syndrome
- Normal obese person
- Cushing’s syndrome of indeterminate cause
- Pituitary adenoma
- Phaeochromocytoma
- Primary adrenal insufficiency
- Secondary adrenal insufficiency
- Primary hyperaldosteronism
- Secondary hyperaldosteronism
- Adrenal medulla
- Zona glomerulosa
- Zona fasciculata
- Zona reticularis
36-year old male presents with hypertension. Lab results: Na+ = 155mmol/L, K+ = 2.9mmol/L, pH = 7.46, low plasma renin activity.
Primary hyperaldosteronism
Choose the most appropriate answer from the list.
- Pituitary dependent Cushing’s disease
- Adrenal tumour causing Cushing’s syndrome
- Ectopic ACTH causing Cushing’s syndrome
- Normal obese person
- Cushing’s syndrome of indeterminate cause
- Pituitary adenoma
- Phaeochromocytoma
- Primary adrenal insufficiency
- Secondary adrenal insufficiency
- Primary hyperaldosteronism
- Secondary hyperaldosteronism
- Adrenal medulla
- Zona glomerulosa
- Zona fasciculata
- Zona reticularis
50-year old female with the following lab results: Na+ = 130mmol/L, K+ = 5.9mmol/L, glucose = 3.4mmol/L, urea = 7.2 mmol/L, Ca2+ = 2.8 mmol/L. A short SynACTHen test shows cortisol = 600nmol/L half an hour after administration.
Secondary adrenal insufficiency
Choose the most appropriate answer from the list.
- Pituitary dependent Cushing’s disease
- Adrenal tumour causing Cushing’s syndrome
- Ectopic ACTH causing Cushing’s syndrome
- Normal obese person
- Cushing’s syndrome of indeterminate cause
- Pituitary adenoma
- Phaeochromocytoma
- Primary adrenal insufficiency
- Secondary adrenal insufficiency
- Primary hyperaldosteronism
- Secondary hyperaldosteronism
- Adrenal medulla
- Zona glomerulosa
- Zona fasciculata
- Zona reticularis
A 45-year old female patient presents with cushingoid features. A dexamethasone suppression test shows undetectable ACTH, cortisol = 750nmol/L.
Adrenal tumour causing Cushing’s syndrome
Choose the most appropriate answer from the list.
- Pituitary dependent Cushing’s disease
- Adrenal tumour causing Cushing’s syndrome
- Ectopic ACTH causing Cushing’s syndrome
- Normal obese person
- Cushing’s syndrome of indeterminate cause
- Pituitary adenoma
- Phaeochromocytoma
- Primary adrenal insufficiency
- Secondary adrenal insufficiency
- Primary hyperaldosteronism
- Secondary hyperaldosteronism
- Adrenal medulla
- Zona glomerulosa
- Zona fasciculata
- Zona reticularis
A 65-year old male patient presents with cushingoid features. A high dose dexamethasone suppression test shows ACTH 25 pmol/L (high), cortisol = 750nmol/L.
Ectopic ACTH causing Cushing’s syndrome
Choose the most appropriate answer from the list.
- Pituitary dependent Cushing’s disease
- Adrenal tumour causing Cushing’s syndrome
- Ectopic ACTH causing Cushing’s syndrome
- Normal obese person
- Cushing’s syndrome of indeterminate cause
- Pituitary adenoma
- Phaeochromocytoma
- Primary adrenal insufficiency
- Secondary adrenal insufficiency
- Primary hyperaldosteronism
- Secondary hyperaldosteronism
- Adrenal medulla
- Zona glomerulosa
- Zona fasciculata
- Zona reticularis
A 28-year old man presents with hypertensive episodes. Lab results: Na+ 140mmol/L, K+ = 4.1mmol/L, random cortisol = 200nmol/L. CT shows an adrenal mass, which region is most likely to be affected?
Adrenal medulla
Choose the most appropriate answer from the list.
- Phaeochromocytoma
- Adrenal CT Scan
- Conn’s syndrome
- Spironolactone
- Cushing’s syndrome
- Zona glomerulosa
- Alpha blockade
- Zona fasciculata
- Beta blockade
- Low dose dexamethasone test
- Surgery
- 24 hour ambulatory blood pressure
- Pituitary MRI
- Aldosterone- renin ratio
- High dose dexamethasone test
- Glucose tolerance test
What is the first line of treatment in phaeochromocytomas?
Alpha blockade
Choose the most appropriate answer from the list.
- Phaeochromocytoma
- Adrenal CT Scan
- Conn’s syndrome
- Spironolactone
- Cushing’s syndrome
- Zona glomerulosa
- Alpha blockade
- Zona fasciculata
- Beta blockade
- Low dose dexamethasone test
- Surgery
- 24 hour ambulatory blood pressure
- Pituitary MRI
- Aldosterone- renin ratio
- High dose dexamethasone test
- Glucose tolerance test
A 25 year old female patient presents with high levels of aldosterone and low levels of renin. On examination the patient is found to be hypertensive.
Conn’s syndrome
Choose the most appropriate answer from the list.
- Phaeochromocytoma
- Adrenal CT Scan
- Conn’s syndrome
- Spironolactone
- Cushing’s syndrome
- Zona glomerulosa
- Alpha blockade
- Zona fasciculata
- Beta blockade
- Low dose dexamethasone test
- Surgery
- 24 hour ambulatory blood pressure
- Pituitary MRI
- Aldosterone- renin ratio
- High dose dexamethasone test
- Glucose tolerance test
A 75 year old lady reports to her GP of very frequent panic attacks. She complains of excessive sweating and following investigations, hypertension is detected and raised levels of catecholamines are found in the urine.
Phaeochromocytoma
Choose the most appropriate answer from the list.
- Phaeochromocytoma
- Adrenal CT Scan
- Conn’s syndrome
- Spironolactone
- Cushing’s syndrome
- Zona glomerulosa
- Alpha blockade
- Zona fasciculata
- Beta blockade
- Low dose dexamethasone test
- Surgery
- 24 hour ambulatory blood pressure
- Pituitary MRI
- Aldosterone- renin ratio
- High dose dexamethasone test
- Glucose tolerance test
A 53 year old male patient presents with constantly high blood pressure. He is an investment banker and initially the elevation is thought to be related to stress. The patient’s Na, K and urea are all normal. His glucose is however taken randomly and is found to be elevated at 7.9mmol/L. What is the first investigation that needs to be carried out in this patient?
24 hour ambulatory blood pressure
Choose the most appropriate answer from the list.
- Phaeochromocytoma
- Adrenal CT Scan
- Conn’s syndrome
- Spironolactone
- Cushing’s syndrome
- Zona glomerulosa
- Alpha blockade
- Zona fasciculata
- Beta blockade
- Low dose dexamethasone test
- Surgery
- 24 hour ambulatory blood pressure
- Pituitary MRI
- Aldosterone- renin ratio
- High dose dexamethasone test
- Glucose tolerance test
Which part of the adrenal cortex produces glucocorticoids in response to the Adrenocorticotrophic hormone ? (ACTH)
Zona fasciculata
