A 43-year-old man is referred with an adrenal mass. He has primary hyperaldosteronism and imaging shows bilateral adrenal adenomas. What is the best next step?
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الإجابة: D. Adrenal venous sampling
Imaging cannot tell which adrenal is producing aldosterone. With bilateral lesions, adrenal venous sampling is the criterion standard to separate a unilateral source (→ adrenalectomy of that side) from bilateral disease (→ spironolactone/eplerenone; surgery not indicated). Bilateral adrenalectomy would leave the patient adrenally insufficient and is not the treatment for bilateral hyperaldosteronism.
ليش كل خيار صح أو غلط
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A
ليش غلط
Venous sampling is the criterion standard for telling a unilateral adenoma from bilateral hyperplasia; if the disease is bilateral, the slide treats it with an aldosterone antagonist (spironolactone or eplerenone) and surgery is not indicated.
✓ Adrenal disorders (2).pdf · p. 13 -
B
ليش غلط
Surgery suits unilateral aldosterone secretion; with bilateral adenomas on imaging, venous sampling (a high aldosterone level on one side) shows whether one side is the source.
✓ Adrenal disorders (2).pdf · p. 13 -
C
ليش غلط
Radiotherapy is not a listed treatment for hyperaldosteronism: bilateral hyperplasia gets aldosterone antagonists and unilateral secretion gets adrenalectomy.
✓ Adrenal disorders (2).pdf · p. 13 -
D
ليش صح
Adrenal venous sampling is the criterion standard to tell a unilateral adenoma from bilateral hyperplasia, and is done when surgery is being considered.
✓ Adrenal disorders (2).pdf · p. 13
- المصدر
- Adrenal disorders (2).pdf · p. 13
Adrenal gland disorders.pdf · p. 1 - المحاضرة
- Primary Hyperaldosteronism · Endocrinology · Module B
- ظهر في
- MED42 ♂ EOM B