A 64-year-old postmenopausal woman with hypertension and BMI 35 has a 3.9 cm right adrenal nodule. No exogenous steroids. ACTH low, cortisol not suppressed by dexamethasone, urine cortisol high. What is the next step?
سؤال مجاني 7 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
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الإجابة: B. Laparoscopic right adrenalectomy
Low ACTH, non-suppressible cortisol and high urinary cortisol with a 3.9 cm right adrenal nodule = ACTH-independent Cushing syndrome from an adrenal adenoma. Treatment is laparoscopic adrenalectomy of that side. Pituitary MRI is for ACTH-dependent disease, and bariatric surgery or metformin treat the consequences, not the cause.
ليش كل خيار صح أو غلط
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A
ليش غلط
Bariatric surgery treats the obesity, not its cause; for operable Cushing syndrome surgery on the tumour is the treatment of choice.
✓ Adrenal disorders (2).pdf · p. 10 -
B
ليش صح
An adrenocortical tumour causing Cushing syndrome is treated by laparoscopic or open adrenalectomy; surgery is the treatment of choice for operable disease.
✓ Adrenal disorders (2).pdf · p. 10 -
C
ليش غلط
Pituitary MRI is for ACTH-dependent disease; with low ACTH (ACTH-independent) the adrenal glands are imaged instead.
✓ Adrenal summary.pdf · p. 2 -
D
ليش غلط
Diabetes is a complication of Cushing syndrome, not its cause; metformin would treat the consequence while the adrenal nodule stays untreated.
✓ Adrenal summary.pdf · p. 2
- المصدر
- Adrenal disorders (2).pdf · p. 10
RT - Adrenal.pdf · p. 9 - المحاضرة
- Cushing's Syndrome · Endocrinology · Module B
- ظهر في
- MED41 ♀ EOM B