A 58-year-old man is referred to your office after evaluation in the ER for abdominal pain. The patient was diagnosed with gastritis, but a CT scan with contrast performed during the workup of his pain revealed a 2-cm adrenal mass. The patient has no history of malignancy and denies erectile dysfunction. Physical examination reveals a BP of 122/78 with no gynecomastia or evidence of Cushing syndrome. His serum potassium is normal. What is the next step in determining whether this patient's adrenal mass should be resected?
سؤال مجاني 2 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: C. Plasma metanephrines and dexamethasone-suppressed cortisol level.
Every adrenal incidentaloma must be screened for pheochromocytoma (plasma metanephrines) and Cushing syndrome (1 mg overnight dexamethasone suppression test), because functioning tumours are resected.
- The aldosterone/renin ratio is added only if the patient is hypertensive (or hypokalaemic) — he is normotensive with normal K⁺.
- Sex hormone levels are not routine without clinical virilization/feminization.
ليش كل خيار صح أو غلط
-
A
ليش غلط
The renin/aldosterone ratio is added only for patients with hypertension; this man's BP is 122/78 with normal potassium, and the choice also omits the metanephrine and cortisol screens.
✓ Adrenal disorders (2).pdf · p. 17 -
B
ليش غلط
Estrogen-secreting tumours cause feminization in men (an adrenal carcinoma clue); he has no gynecomastia, and sex hormones are not part of the work-up all patients undergo.
✓ Adrenal disorders (2).pdf · p. 17 -
C
ليش صح
All incidentaloma patients get screened for Cushing (overnight 1 mg dexamethasone suppression test) and pheochromocytoma (plasma metanephrines).
✓ Adrenal disorders (2).pdf · p. 17 -
D
ليش غلط
Androgen-secreting tumours cause virilization in women; this is a man with no such signs, and testosterone is not part of the work-up all patients undergo.
✓ Adrenal disorders (2).pdf · p. 17
- المصدر
- Adrenal gland disorders.pdf · p. 1
Adrenal disorders (2).pdf · p. 17 - المحاضرة
- Incidental Adrenal Mass · Endocrinology · Module B
- ظهر في
- Endo bank