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Chapter_21:_Adrenal
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tennessee-eleven-green-mirror-angel-island
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Published
07/07/2024
The superior adrenal artery stems from the {{c1::inferior phrenic artery}}
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The middle adrenal artery stems from the {{c1::aorta}}
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The inferior adrenal artery stems from the {{c1::renal artery}}
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The left adrenal vein drains into the {{c1::left renal vein}}
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The right adrenal vein drains into the {{c1::inferior vena cava}}
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The adrenal cortex receives innervation from the {{c1::no innervation :)}}
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The adrenal medulla receives innervation from the {{c1::sympathetic splanchnic nerves}}
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The lymphatic drainage of the adrenal glands goes to the {{c1::subdiaphragmatic}} and {{c2::renal}} lymph nodes
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An asymptomatic adrenal mass is also called a(n) {{c1::incidentaloma}}
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Incidentalomas are discovered in {{c1::1}}-{{c1::2}}% of all abdominal CT scans
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An adrenal incidentaloma should be tested for functionality {{c1::before}} biopsy or surgery(before or after)
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Surgery for an adrenal incidentaloma is indicated if it is non-{{c1::homogenous}} on CT, greater than {{c2::4}}-{{c2::6}} cm, {{c3::functional}}, or i…
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An adrenal incidentaloma is followed with repeat imaging every {{c1::3}} month(s) for {{c1::1}} year(s)
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The most common metastases to the adrenal glands is from the {{c1::lung}}
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An adrenal incidentaloma discovered in a patient with a cancer history undergoes {{c1::biopsy}}
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Aldosterone is secreted from the zona {{c1::glomerulosa}} of the adrenal cortex
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Glucocorticoids are secreted from the zona {{c1::fasciculata}} of the adrenal cortex
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Androgens/estrogens are secreted from the zona {{c1::reticularis}} of the adrenal cortex
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Corticotropin-releasing hormone (CRH) from the hypothalamus causes release of {{c1::ACTH}} from the anterior pituitary
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Aldosterone secretion is stimulated by angiotensin II and {{c1::hyperkalemia}}
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Congenital adrenal hyperplasia is usually caused by {{c2::21β-hydroxylase}} deficiency (most common) or {{c1::11β-hydroxylase}} deficiency
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Congenital adrenal hyperplasia due to 21β-hydroxylase deficiency causes salt {{c1::wasting}}
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Congenital adrenal hyperplasia due to 11β-hydroxylase deficiency causes salt {{c1::saving}}
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The treatment for congenital adrenal hyperplasia is cortisol and {{c1::genitoplasty}}
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Primary hyperaldosteronism is also known as {{c1::Conn's}} syndrome
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Primary hyperaldosteronism is characterized by high aldosterone with {{c1::low}} renin(high or low)
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Secondary hyperaldosteronism is characterized by high aldosterone with {{c1::high}} renin(high or low)
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The most common cause of primary hyperaldosteronism is adrenal {{c1::adenoma}}
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The best test for primary hyperaldosteronism is the {{c1::salt-load suppression}} test, which will show high {{c2::urine aldosterone}}
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Primary hyperaldosteronism is characterized by an aldosterone:renin ratio of greater than {{c1::20}}
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Primary hyperaldosteronism due to an adrenal adenoma is treated with {{c1::adrenalectomy}}
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Primary hyperaldosteronism due to adrenal hyperplasia is treated with {{c1::medical therapy}}
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Prior to operation on an adrenal adenoma for primary hyperaldosteronism, hypertension needs to be controlled and {{c1::potassium}} replaced
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The most common cause of hypocortisolism is {{c1::withdrawal of exogenous steroids}}
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The most common cause of primary hypocortisolism is {{c1::autoimmune}}
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Hypocortisolism is diagnosed with the {{c2::cosyntropin test}}, which involves giving the patient {{c1::ACTH}}
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Acute adrenal insufficiency is treated with fluids, {{c2::dexamethasone}}, and performing a(n) {{c1::cosyntropin test}}
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The most common cause of hypercortisolism is {{c1::exogenous steroids}}
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The most sensitive test for hypercortisolism is {{c1::24-hour urine cortisol}}
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The first step in diagnosing hypercortisolism involves a 24-hour urine cortisol and {{c1::ACTH level}}
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A high ACTH level in hypercortisolism is followed with a(n) {{c1::high-dose dexamethasone suppression}} test
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The most common cause of non-iatrogenic hypercortisolism is {{c1::pituitary adenoma}}
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The 2nd most common cause of non-iatrogenic hypercortisolism is {{c1::ectopic ACTH secretion}}
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The 3rd most common cause of non-iatrogenic hypercortisolism is {{c1::adrenal adenoma}}
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Hypercortisolism from adrenal hyperplasia is treated medically with {{c1::metyrapone}} and {{c2::aminoglutethimide}}
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When the source of ectopic ACTH in hypercortisolism cannot be found or removed, {{c1::bilateral adrenalectomy}} is performed
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Adrenocortical carcinoma is functional (producing hormone) {{c1::50}}% of the time
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Adrenocortical carcinoma is treated with {{c1::radical adrenalectomy}}
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Residual adrenocortical carcinoma after radical adrenalectomy is treated with {{c1::mitotane}}
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The rate limiting enzyme of catecholamine production is {{c1::tyrosine hydroxylase}}
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The enzyme responsible for converting norepinephrine to epinephrine is {{c2::PNMT}} and is only found in the {{c1::adrenal medulla}}
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The enzyme responsible for breaking down catecholamines is {{c1::monoamine oxidase (MAO)}}
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The organ of Zuckerkandl is a chromaffin body derived from neural crest located at the {{c1::bifurcation of the aorta}}
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The 10% rule of pheochromocytomas can be remembered with the mnemonic MBECK{{c1::Malignant}}{{c2::Bilateral}}{{c3::Extra-adrenal}}{{c4::Calcify}}{{c5:…
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Pheochromocytomas are more likely to be found on the {{c1::right}} side(left or right)
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An extra-adrenal pheochromocytoma is more likely to be {{c1::malignant}}(benign or malignant)
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The best test for diagnosing pheochromocytoma is {{c1::urine metanephrines}}
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A nuclear medicine scan that can help identify the location of pheochromocytomas is a(n) {{c1::MIBG scan}}
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A patient with pheochromocytoma will have {{c1::high}} catecholamine levels after a clonidine suppression test(high or low)
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Venography is avoided in pheochromocytoma due to risk of {{c1::hypertensive crisis}}
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Pheochromocytomas are managed preoperatively with volume replacement and {{c1::alpha}}-blockers
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The surgical treatment for a pheochromocytoma is {{c2::adrenalectomy}}, with the first step being ligation of the {{c1::adrenal veins}}
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A drug that inhibits tyrosine hydroxylase is known as {{c1::metyrosine}}
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The most common extra-adrenal location of pheochromocytoma is at the {{c1::organ of Zuckerkandl}}
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A falsely elevated VMA level may be due to {{c1::coffee}}, tea, fruits, vanilla, {{c2::iodine contrast}}, labetalol, or alpha- and beta-blockers
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A rare, benign, asymptomatic tumor of neural crest origin in the adrenal medulla or sympathetic chain is known as a {{c1::ganglioneuroma}}
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