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Week 27: Adrenal Dysfunction > Adrenal Nodules > Flashcards

Flashcards in Adrenal Nodules Deck (11)
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1

The risk of malignancy increases significantly with a tumor size greater than __ cm

4 cm

2

What is the recommended primary adrenal imaging procedure?

CT

3

3 most important criteria on CT when looking at masses

Unenhanced attenuation in HU (<10 indicate benign)
Contrast washout (more than 50% points to benign)
Lesion size

4

MRI for imaging masses

T1 and T2 weighted imaging can distinguish benign adneomas from malignancy and pheos
Adenomas show rapid washout of contrast

5

Fine needle aspiration biopsy

Cannot distinguish a benign adrenal mass from adrenal carcinoma
But it can distinguish between an adrenal tumor and a metastatic tumor
Indicated when there is a suspicion of cancer outside the adrenal gland
Pheos should always be excluded before attempting FNA!! (Can precipitate a hypertensive crisis)

6

1. Suggestive clinical features
2. Lab tests
for pheochromocytoma

1. HTN, paroxysmal symptoms (palpitations, diaphroesis, headache, pallor, tremor)
2. 24 hour urine: fractionated metanephrines and fractionated catecholamines

7

1. Suggestive clinical features
2. Lab tests
for Cushing's syndrome

1. Central obesity, proximal muscle weakness, thin skin, supraclavicular fat, facial plethora
2. 24 hour UFC, midnight salivary, 1mg dexamethasone

8

1. Suggestive clinical features
2. Lab tests
for primary aldosteronism

1. Hypertension, hypokalemia
2. Plasma aldosterone concentration, plasma renin activity

9

1. Suggestive clinical features
2. Lab tests
for adrenocortical carcinoma

1. Mass effect symptoms, symptoms related to excess GC, mineralocorticoid, androgen/estrogen secretion
2. Serum DHEAS, measures of clinically-indicated steroid

10

Treatment for functioning adrenal adenomas, adrenocortical cancer, and adrenal masses

Surgical intervention

11

What does the ratio between left and right aldosterone:cortisol need to be in order to prove lateralization

Over 4