21 Adrenal Gland

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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?

Subdiaphragmatic and renal lymph nodes Signup and view all the answers

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

Functioning tumor Signup and view all the answers

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

> 4–6 cm, non-homogenous, or enlarging Signup and view all the answers

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

Bilateral adrenalectomy Signup and view all the answers

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

PNMT (phenylethanolamine N-methyltransferase) Signup and view all the answers

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

Presence of a large, irregular, or necrotic mass within the adrenal glands Signup and view all the answers

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

Urine metanephrines test 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?

Hypertensive crisis Signup and view all the answers

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

Aortic bifurcation Signup and view all the answers

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

Conversion of tyrosine to dopa Signup and view all the answers

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

Metyrosine Signup and view all the answers

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

Nipride 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?

Carcinomas Signup and view all the answers

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

MEN IIa Signup and view all the answers

What is the primary cause of primary hyperaldosteronism?

Adrenal adenoma Signup and view all the answers

What is the primary cause of Conn's syndrome?

Bilateral idiopathic adrenal hyperplasia Signup and view all the answers

What is the treatment for hyperplasia in hyperaldosteronism?

Spironolactone Signup and view all the answers

What are the symptoms of Conn's syndrome?

Weakness, polydipsia, and polyuria Signup and view all the answers

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

Autoimmune disease Signup and view all the answers

What is the recommended treatment for acute adrenal insufficiency?

Dexamethasone Signup and view all the answers

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

Exogenous steroids Signup and view all the answers

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

High-dose dexamethasone suppression test Signup and view all the answers

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

Small cell lung carcinoma Signup and view all the answers

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

NP-59 scintigraphy Signup and view all the answers

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

NP-59 scintigraphy Signup and view all the answers

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

Serum cortisol levels Signup and view all the answers

21 Adrenal Gland

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Questions and Answers

What is the vascular supply of the inferior adrenal?

Where does the left adrenal vein drain into?

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

Where do the lymphatics drain from the adrenal glands?

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

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

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

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

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

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

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

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

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

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

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

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

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

What is the primary cause of primary hyperaldosteronism?

What is the primary cause of Conn's syndrome?

What is the treatment for hyperplasia in hyperaldosteronism?

What are the symptoms of Conn's syndrome?

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

What is the recommended treatment for acute adrenal insufficiency?

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

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

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

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

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

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

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