Adrenal disease Flashcards Preview

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Flashcards in Adrenal disease Deck (24):
1

signs that mass may be adrenal carcinoma vs. benign

1. look at char. on CT
2. large is worse esp over 6cm
3. growing?
4. hyperfunction?

2

4 types of adrenal hyper

1. pheo- epi
2. cushings - gluco
3. hyperaldosteronism - mineralocorticoids
4. sex hormoes

3

2 times to go to surgery

1. secreting hormones
2. Large and with features of malignancy

4

when to biopsy mass

NEVER before ruling our pheo
- can dump epi
- if ruled out, can biopsy

5

classic triad of pheo

Pain (headache)
Perspiratiokn
Palpitations

6

how to test for pheo

24hr urine
- metanepherines, catecholamine
- creatiinien - to make sure you get a good measure

7

what to test for cuchings

1. make sure it's not exogenous
2. dexamethasone supression test

8

presentation of hyperaldosteron

hypertensions +/- hypokalemia

9

what is seen on test for hyperaldo

high aldo and low renin

10

3 possible causes for unsupressed cortisol

1. high ACTH (pit, ectopic ACTH or CRH)
2. ACTH indep. ( adernal cort.)
3. exogenous - glucocort drug

11

3 steps for adrenal cushings

1. diagnose (urine cortisol and supression test)
2. look for cause of cushings
3. imagining (CT/MRI)

12

role of pathol in adrenal (3)

1. define lesion
2. do patho findings explain clinical findings
3. prognostics

13

basic classification of adrenal lesion in adults

Cortex
- adrenal cortical hyperplasia
- AC adenoma
- AC carcinoma
Medulla
- Adrenal meduallary hyperplasia
- pheo

14

gross patho of a adrenal cortical hypoerplasia

- usually bilateral
- diffusely enlarged gland
- can show nodularity

15

what is functional approach

for each hormonal syndrome there is a different group of pathological entities

16

3 pathos in high glucocorticoids

- adrenal cortical hyperplasia
- AC adenoma
- AC carcinoma

17

*** what will the contralateral adrenal gland look like in a patient with a cortisol secreting AC adenoma

will be atrophic

18

what is the sig. of this

if miss the diagnosis and remove can go into insifficiency crisis

19

how can path. help prevent this

look at the thickness of the non-lesional cortex

20

what is most common causes of increased mineralocort

- adrenal cortical hyperplasia - rare
- AC adenoma - common
- AC carcinoma - V. rare

21

what is most common cause of virilization

almost always AC carcinoma

22

feat. of AC carcinoma

- large >4cm
- weight
- histo features
- can be funct. or not

23

2 cause of excess catecholamines

1. adrenal medullary hypoerplasia
2. pheo

24

def. pheochromocytoma

- 30% familial
- often benign
- can be malig

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