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Flashcards in adrenal tumors Deck (36)
1

is adrenal cancer more often hormonally active or not hormonally active?

60% hormonally active

2

hirsutism, acne, hypokalemia, HTN, fatigue, cancer

hormonally active adrenal cancer

3

tx for adrenal cancer

surgery if smaller

4

how to do surgery on tumors under 6 cm?

laparoscopically

5

most common cause of cushing syndrome

long term steroid use

6

2nd most common cause of cushing syndrome

pituitary overproducing ACTH

7

1st step of dx'ing cushings

check cortisol via urine or blood

8

if positive cortisol test, next step in dx of cushings?

check ACTH

9

if high cortisol, and ACTH is low, then cause of cushings?

adrenal

10

if high cortisol, and ACTH is high or normal, then cause of cushings?

ectopic or pituitary source

11

best method of imaging adrenals

CT scan

12

tx of cushings with adrenal source

surgery + steroids in perioperative period

13

necessary to dx and tx____before any other surgery

pheochromocytoma

14

sweating, HA, tachycardia, nervous attackes, hyperthryoid patients

pheochromocytoma

15

10% rule used for?

pheochromocytoma

16

10% ___lateral, 10%___(malignant or benign); 10% ___in/outside adrenal; 10% _____(multiple/single); 10%____(familial/sporadic)

10% bilateral;
10% malignant;
10% extra-adrenal;
10% multiple;
10% familial;
10% children

17

T or F: clinical sx of pheochromocytoma correlate with size of it

FALSE

18

assc'd conditions with pheochromocytoma (4)

1. NF
2. von hippel lindau disease
3. tuberous sclerosis
4. Men 2a & 2b

19

to dx pheochromocytoma, can run a plasma _______, or a urine _____

plasma metanephrine; urine catacholamines/metanephrines

20

best imaging modality for pheochromocytoma

CT

21

pre-op prep for pheochromocytoma: give ____, followed by _____ if persistent tachycardia

1. alpha blocker - phenyoxybenzamine
2. beta blocker

22

in pheochromocytoma, what must you control early?

adrenal vein

23

failure to suppress aldosterone secretion by intravascular volume expansion

primary hyperaldosteronism

24

what is one of the more more common causes of secondary HTN?

Conn's syndrome

25

Primary aldosteronism is AKA?

conn's syndrome

26

what to consider when someone has drug resistance HTN?

conn's syndrome

27

how to tx aldosterone producing adenoma (APA)

surgery

28

how to tx bilateral idiopathic hyperaldosteronism

spironolactone (aldosterone antagonists)

29

screening test for primary hyperaldosteronism

aldosterone: renin ratio

30

confirmatory tests for primary hyperaldosteronism (2)

1. 24 hr urine aldosterone
2. saline suppression test

31

best way to look for primary hyperaldosteronism

CT

32

adrenal incidentaloma is most commonly due to?

nonfxnl (nothing)

33

how to check for hypercortisolism?

dexamethasone suppression test

34

how to test for hyperaldosteronism

aldosterone

35

how to check pheochromocytoma

serum metanphrines or urine

36

adrenal incidentaloma f/u recommendations: f/u CT at _____, again at _____ then stop if asymptomatic

3-6 mon; 1 year