21 Adrenal Gland

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Questions and Answers

What is the vascular supply of the inferior adrenal?

  • Inferior phrenic artery
  • Aorta
  • Renal artery (correct)
  • Inferior vena cava

Where does the left adrenal vein drain into?

  • Superior vena cava
  • Inferior vena cava
  • Left renal vein (correct)
  • Hepatic portal vein

Which part of the adrenal receives innervation from the sympathetic splanchnic nerves?

  • Adrenal cortex
  • Superior adrenal
  • Adrenal medulla (correct)
  • Inferior adrenal

Where do the lymphatics drain from the adrenal glands?

<p>Subdiaphragmatic and renal lymph nodes (B)</p> Signup and view all the answers

What should be checked for before biopsy or surgery for an asymptomatic adrenal mass?

<p>Functioning tumor (C)</p> Signup and view all the answers

When is surgery indicated for an asymptomatic adrenal mass according to CT scan characteristics?

<p>&gt; 4–6 cm, non-homogenous, or enlarging (C)</p> Signup and view all the answers

What is the first-line treatment for inoperable adrenal hyperplasia?

<p>Bilateral adrenalectomy (A)</p> Signup and view all the answers

Which enzyme is responsible for converting norepinephrine to epinephrine in the adrenal medulla?

<p>PNMT (phenylethanolamine N-methyltransferase) (D)</p> Signup and view all the answers

Which finding on a CT scan suggests a diagnosis of adrenocortical carcinoma?

<p>Presence of a large, irregular, or necrotic mass within the adrenal glands (D)</p> Signup and view all the answers

What is the first-line test for localization of a pheochromocytoma?

<p>Urine metanephrines test (A)</p> Signup and view all the answers

What is the main risk associated with giving a β-blocker before an α-blocker in a patient with pheochromocytoma?

<p>Hypertensive crisis (A)</p> Signup and view all the answers

Where is the most common extramedullary tissue site for extra-adrenal pheochromocytomas?

<p>Aortic bifurcation (D)</p> Signup and view all the answers

What is the rate-limiting step in catecholamine production in the adrenal medulla?

<p>Conversion of tyrosine to dopa (A)</p> Signup and view all the answers

Which medication inhibits tyrosine hydroxylase causing a decrease in catecholamine synthesis?

<p>Metyrosine (D)</p> Signup and view all the answers

What is the recommended first-line treatment for persistent hypertension postoperatively in pheochromocytoma?

<p>Nipride (D)</p> Signup and view all the answers

What type of tumors are associated with precocious puberty in boys, virilization in females, and Cushing’s syndrome in children?

<p>Carcinomas (A)</p> Signup and view all the answers

What is the most common associated syndrome with extra-adrenal pheochromocytomas?

<p>MEN IIa (C)</p> Signup and view all the answers

What is the primary cause of primary hyperaldosteronism?

<p>Adrenal adenoma (B)</p> Signup and view all the answers

What is the primary cause of Conn's syndrome?

<p>Bilateral idiopathic adrenal hyperplasia (D)</p> Signup and view all the answers

What is the treatment for hyperplasia in hyperaldosteronism?

<p>Spironolactone (C)</p> Signup and view all the answers

What are the symptoms of Conn's syndrome?

<p>Weakness, polydipsia, and polyuria (C)</p> Signup and view all the answers

What is the primary cause of hypocortisolism (Addison's disease)?

<p>Autoimmune disease (A)</p> Signup and view all the answers

What is the recommended treatment for acute adrenal insufficiency?

<p>Dexamethasone (B)</p> Signup and view all the answers

What is the most common cause of Cushing's syndrome?

<p>Exogenous steroids (C)</p> Signup and view all the answers

How is Cushing's disease (pituitary adenoma) primarily diagnosed?

<p>High-dose dexamethasone suppression test (D)</p> Signup and view all the answers

What is the most common source of ectopic ACTH in Cushing's syndrome?

<p>Small cell lung carcinoma (D)</p> Signup and view all the answers

What investigation can help localize tumors and differentiate adrenal adenomas from hyperplasia?

<p>NP-59 scintigraphy (B)</p> Signup and view all the answers

The first-line test for localization of a pheochromocytoma is:

<p>NP-59 scintigraphy (B)</p> Signup and view all the answers

What should be checked for before biopsy or surgery for an asymptomatic adrenal mass?

<p>Serum cortisol levels (C)</p> Signup and view all the answers

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