URR 61 Flashcards
(100 cards)
1
Q
Cushing disease is usually caused by a:
A
pituitary tumor
2
Q
Labs associated with Cushing Disease
A
increased ACTH
increased cortisol
increased glucose
3
Q
Hypersecretion of ACTH by the pituitary gland causes increased ___ production by the adrenal gland
A
cortisol
4
Q
Increased cortisol production by the adrenal glands causes increased ____ production
A
glucose
5
Q
Cushing Disease can lead to ____
A
Cushing Syndrome
6
Q
Cushing disease is characterized by:
A
truncal obesity
hirsutism
amenorrhea
HTN
fatigue
hyperglycemia
7
Q
Sonographic appearance of Cushing Disease
A
glands can be diffusely enlarged with areas of necrosis/hemorrhage
8
Q
Most commonly caused by steroid based medications
A
Cushing Syndrome
9
Q
Cushing syndrome is caused by excessive cortisol excretion due to ___, ___, or ___
A
adrenal hyperplasia
adrenal adenoma
adrenal carcinoma
10
Q
Cushing Syndrome caused by Cushing disease =
A
elevated ACTH and cortisol
11
Q
Cushing syndrome caused by steroid use or adrenal tumor =
A
elevated cortisol only
12
Q
Cushing syndrome is characterized by:
A
truncal obesity
purple stretch marks on the side and lower abdomen
hirsutism
amenorrhea
HTN
fatigue
hyperglycemia
13
Q
Other related findings to Cushing Syndrome
A
diabetes
HTN
edema
cardiomegaly
adrenal rest tumors (scrotal tumor)
14
Q
Sonographic appearance of Cushing Syndrome
A
glands can be diffusely enlarged with areas of necrosis/hemorrhage
15
Q
caused by aldosterone producing adrenal tumor, aldosternoma
A
Conn Syndrome
16
Q
aldosterone producing adrenal tumor
A
aldosteronoma
17
Q
Symptoms of Conn Syndrome
A
salt retention
HTN
thirst
increased urination
weakness
EKG abnormalities
18
Q
Lab testing associated with Conn Syndrome
A
Elevated serum levels of sodium
decreased serum levels of potassium
19
Q
elevated serum levels of sodium
A
hyperanetremia
20
Q
decreased serum levels of potassium
A
hypokalemia
21
Q
____ and ___ will increase urine output and reduce blood volume in the body
A
hypernatremia
hypokalemia
22
Q
Sonographic appearance of Conn syndrome
A
glands can be diffusely enlarged with areas of necrosis/hemorrhage
23
Q
most common adrenal tumor
A
adenoma
24
Q
most common adrenal incidentaloma
A
adenoma
25
unexpected mass found during imaging procedures
incidentaloma
26
unilateral adrenal mass; usually <3m in size; can be functional or nonfunctional;
adenoma
27
___ adrenal adenoma is most common form.
Non-functioning
28
____ adrenal adenomas do not affect gland function and requires no treatment unless it gets too big
non-functioning
29
___ adrenal adenoma causes increased adrenal function and requires treatment/surgery
functional
30
Larger lesions on the adrenal gland are more likely to be ____ adenomas.
functional
31
Large functional adenomas may cause ___ or ___
Cushing Syndrome
Conn Syndrome
32
Adrenal adenomas may be a part of ____
multiple endocrine neoplasia syndrome
33
_____ on multiphase CT exam can help differentiate an adrenal adenoma from an adrenal malignancy which exhibits ___
rapid contrast washout
no washout
34
Sonographic appearance of adrenal adenoma
hypoechoic solid mass formed in cortical tissue of gland
usually homogeneous with NO necrosis or cystic components
35
Neoplasm formation due to abnormal proliferation of cortical cells
Adrenal cortical cancer
36
Adrenal cortical cancer tumors can be pretty large: >__cm
6
37
Lab testing for adrenal cortical cancer
elevated androgen levels
38
Adrenal cortical cancer is associated with ___ due to excessive androgen production
hirsutism
39
Most patients who have adrenal cortical cancer also have ____ because the tumor causes excess cortisol production
Cushing syndrome
40
Adrenal cortical cancer shows ___ washout on Ct exam
no
41
Sonographic appearance of adrenal cortical cancer
demonstrates complex appearance with hypoechoic solid components and cystic changes
very aggressive, metastasis is common
can invade renal vein and IVC
42
malignant tumor of the medulla of the adrenal gladn
neuroblastoma
43
2nd most common abdominal tumor in pediatric patients
neuroblastoma
44
Neuroblastomas usually present in younger children, <__ years of age
5
45
Neuroblastoma can also occur in the __ and __ area
chest
neck
46
Symptoms of neuroblastoma:
tachycardia
night sweats
headaches
47
Lab tests associated with neuroblastoma
increased levels of norepinephrine, epinephrine, and dopamine in the blood and urin
48
Sonographic appearance of neuroblastoma
large echogenic, heterogeneous mass that does NOT distort renal contour, but can displace the kidney inferiorly
internal vascularity
49
Evaluate kidney contour related to mass to determine __ vs ___ origin
adrenal
renal
50
Adrenal glands are commonly affected by ____
Non-Hodgkin lymphoma
51
sonographic appearance of adrenal lymphoma
usually bilateral; diffuse enlargement of the gland with varied echogenicity
52
most common primaries to metastasize to the adrenal glands
lung
breast
kidney
melanoma
53
can be unilateral or bilateral; demonstrate delayed contrast washout on CT evaluation; solid mass with heterogeneous appearance
adrenal metastasis
54
most commonly occurs in newborns and is caused by the birthing process
adrenal hemorrhage
55
____ are usually benign and hyperfunctioning
pheochromocytomas
56
Addison disease is most commonly associated with ____
autoimmune disorders
57
Cushing disease is most commonly caused by a ___
pituitary tumor
58
Cushing Syndrome is most commonly caused by ___
chronic steroid use
59
_____ are the most common adrenal tumor
non-functioning adrenal adenomas
60
most common adrenal incidentaloma
adenomas
61
2nd most common abdominal tumors in pediatric patients
neuroblastomas
62
Most common primary cancers that metastasize to the adrenal glands are __, ___, __, __, and ___
lung
breast
kidney
melanoma
63
The right adrenal gland is:
a. triangle shaped
b. lateral to the right lobe of the liver
c. anterior to the IVC
d. all the above
a
64
The left adrenal gland is:
a. medial to the spleen
b. posterior to the pancreas tail and stomach
c. lateral to the aorta
d. all the above
d
65
A left adrenal mass can cause anterior displacement the __, while a right adrenal mass can cause anterior displacement of the __
a. aorta, ivc
b. pancreatic tail, ivc
c. ivc, portal vein
d. pancreatic tail, aorta
b
66
Which of the following controls the function of the adrenal cortex?
a. cortisol
b. aldosterone
c. adrenocorticotropic hormone
d. epinephrine
c
67
__ is responsible for fluid and electrolyte regulation, while __ is responsible for metabolism regulation.
a. cortisol, aldosterone
b. adrenocorticotropic hormone, cortisol
c. aldosterone, cortisol
d. epinephrine, norepinephrine
c
68
Norepinephrine and epinephrine have what effect on the body?
a. control digestion efficiency
b. control heart rate and blood pressure
c. control weight gain/loss
d. control kidney filtration
b
69
All the following are produced by the adrenal cortex, except:
a. testosterone
b. cortisol
c. aldosterone
d. adrenocorticotropic hormone
d
70
Aldosterone levels increase with:
a. adrenal adenoma
b. adrenal adenocarcinoma
c. bilateral adrenal hyperplasia
d. all the above
d
71
Which of the following levels decreases with Addison disease or adrenal insufficiency?
a. cortisol
b. norepinephrine
c. testosterone
d. epinephrine
a
72
Which of the following is monitored in patients with infertility or delayed/early puberty?
a. cortisol
b. norepinephrine
c. testosterone
d. epinephrine
c
73
The normal sonographic appearance of an adrenal gland is:
a. medulla appears as a hypoechoic linear structure
b. cortex is hypoechoic to the medulla and surrounding fat
c. cortex is hyperechoic to the medulla and surrounding fat
d. the cortex and medulla are isoechoic and indistinguishable from each other
b
74
Which of the following levels will be reduced in lab testing of a newborn with an isolated adrenal hemorrhage?
a. aldosterone
b. testosterone
c. cortisol
d. hematocrit
d
75
Which of the following is a mass of the adrenal medulla that causes increased secretion of dopamine, epinephrine, and norepinephrine?
a. myelolipoma
b. pheochromocytoma
c. lymphoma
d. metastasis
b
76
Which of the following is an adrenal mass composed of bone and fatty elements that result in propagation speed artifact?
a. myelolipoma
b. pheochromocytoma
c. lymphoma
d. adenoma
a
77
Which of the following is caused by hypersecretion of ACTH that results in no change to cortisol production?
a. Conn Syndrome
b. Cushing disease
c. Addison Disease
d. Adrenal hemorrhage
c
78
Which of the following is caused by hypersecretion of ACTH by the pituitary gland which leads to overproduction of cortisol?
a. Conn Syndrome
b. Cushing disease
c. Addison disease
d. Adrenal hemorrhage
b
79
What is the difference between Cushing syndrome caused by Cushing disease and Cushing syndrome caused by an adrenal tumor?
a. ACTH levels
b. Cortisol levels
c. epinephrine levels
d. norepinephrine levels
a
80
Which of the following presents as hypernatremia and hypokalemia?
a. Conn Syndrome
b. Cushing disease
c. Addison disease
d. Adrenal hemorrhage
a
81
An adrenal adenoma is a part of what syndrome?
a. Multiple endocrine neoplasia syndrome
b. addison syndrome
c. adrenogenital syndrome
d. von hippel lindau syndrome
a
82
A pheochromocytoma is a part of what syndrome?
a. Wolman disease
b. Addison Syndrome
c. Adrenogenital syndrome
d. von hippel lindau syndrome
d
83
What is the typical sonographic appearance of an adrenal adenoma?
a. hyperechoic mass with central necrosis
b. hypoechoic mass with central necrosis
c. hypoechoic solid mass
d. hyperechoic solid mass
c
84
Most patients with adrenal cortical cancer also have:
a. Conn syndrome
b. Addison disease
c. Cushing syndrome
d. An adrenal hemorrhage
c
85
What characteristic differentiates a renal mass from a neuroblastoma in an infant?
a. renal contour
b. adrenal contour
c. blood flow to the mass
d. size of the tumor
a
86
Which of the following is a common primary carcinoma that metastasizes to the adrenal gland?
a. lung
b. breast
c. melanoma
d. all the above
d
87
Chest sonography exams
pleural effusion and empyema
pneumonia
atelyactasis
sequestration
chest/mediastinal masses
congenital airway malformations
diaphragm paralysis, hernia, or rupture
rib fractures
pneumothorax
intravascular catheter position
88
US guidance can be used for ___ and __
thoracentesis
biopsy
89
Chest sonography transducer choice
5-15 MHz linear
90
M-mode in the chest is used to evaluate suspected ___
pneumothorax
91
Color Doppler imaging is used to demonstrate vascular supply, which is necessary in the diagnosis of ___
sequestration
92
Real time sonography is used to document ____ and compare right and left sides
diaphragmatic motion
93
In infants, the ___, ___, and ___ provide an acoustic window in the chest.
sternum
thymus
costal cartilage
94
In adolescent and adults, transabdominal imaging uses the __ and the __ as a window to evaluate the diaphragm.
liver
spleen
95
The thymus is a gland that is part of the ___ system
endocrine
96
Initially, the thymus produces ___ that helps boost the immune system
thymosin
97
After puberty, the thymus ___ and goes through ___
shrinks
fatty replacement
98
The thymus is located behind the ___ and between the ___
sternum
lungs
99
The thymus is anterior to the ___ and it extends inferior to a position just superior to the ___
great vessels
heart
100
In infants and children, the __, __, and __ are well visualized using the thymus as an acoustic window
SVC
aorta
pulmonary artery
