A 55-year-old man has been recently hospitalized for abdominal pain due to gallstone pancreatitis. During his hospitalization, he has an abdominal CT scan that shows an incidental finding of right adrenal mass 2x1 cm. He has T2DM and dyslipidemia. His current medications are atorvastatin and metformin. On examination, HR 80/min, and BP 138/80 mmHg. His investigations show normal renal function and HbA1c is 7.1% Which of the following Laboratory tests should be done to evaluate his adrenal mass?
سؤال مجاني 2 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
المصادر مختلفة. ملفات الدفعة فيها إجابتين، وما نرجّح وحدة على الثانية. سبب كل وحدة في الشرح تحت:
- إجابة: B. Overnight dexamethasone suppression test and 24-hour urinary metanephrines
- إجابة ثانية: D. Overnight dexamethasone suppression test, plasma aldosterone renin ratio, and 24-hour urinary metanephrines
In the lecture, every adrenal incidentaloma is screened for cortisol excess (overnight 1 mg dexamethasone suppression test) and pheochromocytoma (metanephrines). The aldosterone/renin ratio is added only for hypertensive patients (or those with hypokalemia). This man is on no antihypertensives, has no stated hypokalemia, and has a single BP of 138/80, so the source-based minimum is B. The old key D assumes he counts as hypertensive (138/80 sits in the AHA stage 1 range), which the stem leaves unclear.
ليش كل خيار صح أو غلط
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A
ليش غلط
Leaves out the cortisol-excess screen: the Endocrine lecture lists a dexamethasone suppression test, with metanephrines, as part of the incidentaloma investigations.
✓ Endocrine ✳️.pdf · p. 27 -
B
ليش صح
Supported by the Endocrine lecture: incidentaloma investigations include a dexamethasone suppression test plus metanephrines, and mineralocorticoid (aldosterone) levels are listed for hypertensive patients.
✓ Endocrine ✳️.pdf · p. 27 -
C
ليش غلط
Leaves out the pheochromocytoma screen: the Endocrine lecture lists urine or plasma metanephrines, with a dexamethasone suppression test, as part of the incidentaloma investigations.
✓ Endocrine ✳️.pdf · p. 27 -
D
ليش صح
Supported by the Adrenal disorders lecture: all patients get Cushing and pheochromocytoma screens, and patients with hypertension also get the renin/aldosterone ratio; D fits if he counts as hypertensive.
✓ Adrenal disorders (2).pdf · p. 17
- المصدر
- Adrenal disorders (2).pdf · p. 17
Endocrine ✳️.pdf · p. 27 - المحاضرة
- Incidental Adrenal Mass · Endocrinology · Module B
- ظهر في
- Endo bank · MED41 ♂ EOM B