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</p> Signup and view all the answers

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

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

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

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

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

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

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

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

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

    <p>Metyrosine</p> Signup and view all the answers

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

    <p>Nipride</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</p> Signup and view all the answers

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

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

    What is the primary cause of primary hyperaldosteronism?

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

    What is the primary cause of Conn's syndrome?

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

    What is the treatment for hyperplasia in hyperaldosteronism?

    <p>Spironolactone</p> Signup and view all the answers

    What are the symptoms of Conn's syndrome?

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

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

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

    What is the recommended treatment for acute adrenal insufficiency?

    <p>Dexamethasone</p> Signup and view all the answers

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

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

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

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

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

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

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

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

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