Flashcards in adrenal tumors Deck (36)
is adrenal cancer more often hormonally active or not hormonally active?
60% hormonally active
hirsutism, acne, hypokalemia, HTN, fatigue, cancer
hormonally active adrenal cancer
tx for adrenal cancer
surgery if smaller
how to do surgery on tumors under 6 cm?
most common cause of cushing syndrome
long term steroid use
2nd most common cause of cushing syndrome
pituitary overproducing ACTH
1st step of dx'ing cushings
check cortisol via urine or blood
if positive cortisol test, next step in dx of cushings?
if high cortisol, and ACTH is low, then cause of cushings?
if high cortisol, and ACTH is high or normal, then cause of cushings?
ectopic or pituitary source
best method of imaging adrenals
tx of cushings with adrenal source
surgery + steroids in perioperative period
necessary to dx and tx____before any other surgery
sweating, HA, tachycardia, nervous attackes, hyperthryoid patients
10% rule used for?
10% ___lateral, 10%___(malignant or benign); 10% ___in/outside adrenal; 10% _____(multiple/single); 10%____(familial/sporadic)
T or F: clinical sx of pheochromocytoma correlate with size of it
assc'd conditions with pheochromocytoma (4)
2. von hippel lindau disease
3. tuberous sclerosis
4. Men 2a & 2b
to dx pheochromocytoma, can run a plasma _______, or a urine _____
plasma metanephrine; urine catacholamines/metanephrines
best imaging modality for pheochromocytoma
pre-op prep for pheochromocytoma: give ____, followed by _____ if persistent tachycardia
1. alpha blocker - phenyoxybenzamine
2. beta blocker
in pheochromocytoma, what must you control early?
failure to suppress aldosterone secretion by intravascular volume expansion
what is one of the more more common causes of secondary HTN?
Primary aldosteronism is AKA?
what to consider when someone has drug resistance HTN?
how to tx aldosterone producing adenoma (APA)
how to tx bilateral idiopathic hyperaldosteronism
spironolactone (aldosterone antagonists)
screening test for primary hyperaldosteronism
aldosterone: renin ratio
confirmatory tests for primary hyperaldosteronism (2)
1. 24 hr urine aldosterone
2. saline suppression test
best way to look for primary hyperaldosteronism
adrenal incidentaloma is most commonly due to?
how to check for hypercortisolism?
dexamethasone suppression test
how to test for hyperaldosteronism
how to check pheochromocytoma
serum metanphrines or urine