A patient with confirmed primary hyperaldosteronism has a CT showing a unilateral adrenal adenoma. What should be done next?
سؤال مجاني 1 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: A. Adrenal venous sampling
In confirmed primary hyperaldosteronism, CT is the initial localising test, but adrenal venous sampling is done after biochemical confirmation and before surgery to prove the adenoma is the unilateral source (CT 'adenomas' may be non-functioning). If AVS lateralises → laparoscopic adrenalectomy (so B comes after A). Spironolactone is for bilateral hyperplasia or non-surgical patients.
ليش كل خيار صح أو غلط
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A
ليش صح
Adrenal venous sampling is done after biochemical confirmation and before surgery, to separate a unilateral adenoma (surgical candidate) from bilateral hyperplasia (medical management).
✓ Adrenal gland disorders.pdf · p. 1 -
B
ليش غلط
Surgery helps only if the adenoma is the source (HTN from hyperplasia is not helped by bilateral adrenalectomy), so venous sampling comes first in patients pursuing surgery.
✓ Step Up To Medicine 6th Edition 2024 (Adrenal).pdf · p. 9 -
C
ليش غلط
Spironolactone is for bilateral hyperplasia or for patients who are poor surgical candidates, not the next step for a unilateral adenoma awaiting confirmation.
✓ Adrenal disorders (2).pdf · p. 13
- المصدر
- Adrenal gland disorders.pdf · p. 1
Step Up To Medicine 6th Edition 2024 (Adrenal).pdf · p. 9
Adrenal disorders (2).pdf · p. 13 - المحاضرة
- Primary Hyperaldosteronism · Endocrinology · Module B
- ظهر في
- MED42 Compre B