Adrenal Disease: Definition, Classification, Diagnosis, and Management

Question 1

Which imaging modality is typically the first choice for evaluating an adrenal mass?

Accepted Answer

Computed tomography (CT)

Answer

Ultrasound

Answer

Magnetic resonance imaging (MRI)

Answer

Radionuclide scan

Question 2

What is the first-line medical treatment for primary hyperaldosteronism?

Accepted Answer

Spironolactone

Answer

Eplerenone

Answer

Amiloride

Answer

Triamterene

Question 3

Which of the following is a potential life-threatening complication of adrenal insufficiency?

Accepted Answer

Hypovolemic shock

Answer

Hyperkalemia

Answer

Hypoglycemia

Answer

Hypertension

Question 4

What is the most common type of functional adrenal tumor?

Accepted Answer

Pheochromocytoma

Answer

Adrenocortical carcinoma

Answer

Ganglioneuroma

Answer

Neuroblastoma

Question 5

Which of the following is a characteristic biochemical finding in pheochromocytoma?

Accepted Answer

Elevated plasma metanephrines

Answer

Increased cortisol levels

Answer

Decreased aldosterone levels

Answer

Low ACTH

Question 6

What is the gold standard test for diagnosing adrenal hyperplasia?

Accepted Answer

Adrenocorticotropic hormone (ACTH) stimulation test

Answer

Dexamethasone suppression test

Answer

Plasma renin activity measurement

Answer

Ultrasound of the adrenals

Question 7

Which adrenal gland hormone regulates blood pressure and fluid balance?

Accepted Answer

Aldosterone

Answer

Cortisol

Answer

Adrenaline

Answer

Noradrenaline

Question 8

What is the most common cause of primary adrenal insufficiency (Addison's disease)?

Accepted Answer

Autoimmune disease

Answer

Addison's disease

Answer

Cushing's syndrome

Answer

Pheochromocytoma

Question 9

Which of the following is a typical physical finding in Cushing's syndrome?

Accepted Answer

Weight gain and obesity, especially around the face and trunk

Answer

Hypertension

Answer

Hypoglycemia

Answer

Polyuria

Question 10

What is the first-line pharmacological treatment for Conn's syndrome (primary hyperaldosteronism)?

Accepted Answer

Mineralocorticoid receptor antagonists (e.g., spironolactone)

Answer

Adrenocorticotropic hormone (ACTH)

Answer

Glucocorticoids

Answer

Surgery

Question 11

What is the most common cause of secondary adrenal insufficiency?

Accepted Answer

Pituitary disease

Answer

Hypothalamic disease

Answer

Adrenal disease

Answer

Trauma

Question 12

What is the initial treatment of choice for adrenal crisis?

Accepted Answer

Hydrocortisone

Answer

Fludrocortisone

Answer

Dexamethasone

Answer

Prednisone

Question 13

What is the most prevalent cause of primary hyperaldosteronism?

Accepted Answer

Adrenal adenoma

Answer

Alcoholism

Answer

Cushing's disease

Answer

Adrenal carcinoma

Question 14

In managing adrenal disease, which fundamental principle guides the choice between pharmacological and surgical approaches?

Accepted Answer

Medical management is generally preferred initially, with surgery reserved for specific scenarios.

Answer

Surgery is the exclusive treatment for all adrenal disease cases.

Answer

Pharmacological interventions are ineffective in treating adrenal disease.

Answer

The decision between medical or surgical intervention is solely based on the adrenal mass's size.

Question 15

Which of the following is the most prevalent cause of primary hyperaldosteronism?

Accepted Answer

An adrenal adenoma

Answer

Adrenal hyperplasia

Answer

Ectopic ACTH secretion

Answer

A pheochromocytoma

Question 16

For primary adrenal insufficiency, what is the first-line treatment?

Accepted Answer

Administering hydrocortisone

Answer

Administering prednisone

Answer

Administering fludrocortisone

Answer

Administering dexamethasone

Question 17

Which of the following is NOT a risk factor associated with developing adrenal cancer?

Accepted Answer

Diabetes mellitus

Answer

Li-Fraumeni syndrome

Answer

Beckwith-Wiedemann syndrome

Answer

A history of radiation exposure

Question 18

Which type of adrenal adenoma is most common?

Accepted Answer

A non-functional adenoma

Answer

A functional adenoma

Answer

A pheochromocytoma

Answer

A ganglioneuroma

Question 19

Regarding congenital adrenal hyperplasia caused by 21-hydroxylase deficiency, which clinical feature is present?

Accepted Answer

Ambiguous genitalia in females

Answer

Premature puberty in males

Answer

Hypertension

Answer

Hyponatremia

Question 20

When evaluating an adrenal mass, what is the suggested initial imaging study?

Accepted Answer

A CT scan

Answer

An MRI scan

Answer

An ultrasound

Answer

A PET scan

Question 21

Which hormone plays a crucial role in regulating blood pressure and maintaining fluid balance?

Accepted Answer

Aldosterone

Answer

Cortisol

Answer

Adrenaline

Answer

Epinephrine

Question 22

Which type of adrenal disorder is characterized by excessive production of cortisol?

Accepted Answer

Cushing's syndrome

Answer

Addison's disease

Answer

Pheochromocytoma

Answer

Congenital adrenal hyperplasia

Question 23

Which imaging technique is primarily used for diagnosing adrenal tumors?

Accepted Answer

Computed tomography (CT) scan

Answer

Ultrasound

Answer

Magnetic resonance imaging (MRI) scan

Answer

Positron emission tomography (PET) scan

Question 24

Which hormone is essential for the proper development of the fetus during pregnancy?

Accepted Answer

Dehydroepiandrosterone (DHEA)

Answer

Cortisol

Answer

Aldosterone

Answer

Estrogen

Question 25

Which of the following clinical presentations is a hallmark of primary aldosteronism?

Accepted Answer

Hypertension and hypokalemia

Answer

Cushingoid features and hyperglycemia

Answer

Weight loss and hyperpigmentation

Answer

Hypertension and tachycardia

Question 26

What is the most common cause of primary hyperaldosteronism?

Accepted Answer

Adrenal adenoma

Answer

Bilateral adrenal hyperplasia

Answer

Adrenal carcinoma

Answer

Ectopic aldosterone secretion

Question 27

What is the primary treatment for adrenal insufficiency?

Accepted Answer

Glucocorticoid replacement

Answer

Mineralocorticoid replacement

Answer

Adrenocorticotropic hormone (ACTH) replacement

Answer

Surgery

Question 28

Which of the following is a potential complication of adrenalectomy?

Accepted Answer

Addison's crisis

Answer

Hypertension

Answer

Diabetes mellitus

Answer

Osteoporosis

Question 29

What is the primary pathophysiological mechanism underlying Conn's syndrome?

Accepted Answer

Excessive aldosterone secretion

Answer

Excessive cortisol secretion

Answer

Excessive epinephrine secretion

Answer

Excessive norepinephrine secretion

Question 30

What is the most common cause of secondary adrenal insufficiency?

Accepted Answer

Pituitary adenoma

Answer

Adrenalectomy

Answer

Tuberculosis

Answer

Autoimmune disease

Question 31

Specifically, what hormone is secreted by the adrenal medulla in response to stress?

Accepted Answer

Epinephrine

Answer

Dopamine

Answer

Serotonin

Answer

Estrogen

Question 32

Identify the two distinct anatomical regions that comprise the adrenal glands:

Accepted Answer

Cortex and Medulla

Answer

Anterior and Posterior

Answer

Zona Glomerulosa and Zona Fasciculata

Answer

Zona Reticularis and Zona Granulosa

Question 33

Elaborate on the primary role of the adrenal cortex in maintaining physiological homeostasis:

Accepted Answer

Regulation of blood pressure and electrolyte balance

Answer

Coordination of the stress response

Answer

Metabolism of carbohydrates and proteins

Answer

Modulation of immune system function

Question 34

Describe a prominent clinical manifestation associated with Cushing's syndrome, a condition arising from excessive cortisol secretion:

Accepted Answer

Weight gain

Answer

Muscle weakness

Answer

Hypertension

Answer

Increased thirst

Question 35

In the management of primary aldosteronism, characterized by excessive production of aldosterone, what therapeutic approach is typically employed as the first-line treatment?

Accepted Answer

Mineralocorticoid receptor antagonists

Answer

Beta-blockers

Answer

ACE inhibitors

Answer

Adrenalectomy

Question 36

Identify the most prevalent cause of adrenal insufficiency, a condition characterized by insufficient adrenal hormone production:

Accepted Answer

Autoimmune disease

Answer

Tuberculosis

Answer

Adrenalectomy

Answer

Pituitary tumor

Question 37

In the clinical management of an adrenal mass, which therapeutic approach is generally recommended?

Accepted Answer

Surgical resection

Answer

Medical observation

Answer

Radiation therapy

Answer

Chemotherapy

Question 38

Which pathophysiological mechanism is central to adrenal insufficiency? Explain the role of the hypothalamic-pituitary-adrenal (HPA) axis in this process.

Accepted Answer

Deficient cortisol and aldosterone secretion due to impaired adrenal function

Answer

Elevated ACTH levels due to impaired adrenal feedback

Answer

Dysfunction of the sympathetic nervous system

Answer

Adrenal gland hyperplasia

Question 39

Congenital adrenal hyperplasia due to 21-hydroxylase deficiency is inherited in an autosomal recessive pattern. Explain the implications of this inheritance pattern for family counseling.

Accepted Answer

Siblings have a 25% risk of inheriting the condition.

Answer

Siblings have a 50% risk of inheriting the condition.

Answer

Only males can be affected.

Answer

Only females can be affected.

Question 40

A patient presents with hyponatremia, hyperkalemia, and decreased plasma renin activity. Which of the following is the most likely underlying cause?

Accepted Answer

Addison's disease

Answer

Primary aldosteronism

Answer

Cushing's syndrome

Answer

Pheochromocytoma

Question 41

Which of the following is the most commonly occurring adrenal cortical neoplasm?

Accepted Answer

Adenoma

Answer

Ganglioneuroma

Answer

Neuroblastoma

Answer

Pheochromocytoma

Question 42

In the evaluation of suspected adrenal disease, which imaging modality is typically employed as the initial diagnostic tool?

Accepted Answer

CT scan

Answer

Ultrasound

Answer

MRI scan

Question 43

Among the following, which is a contraindication to surgical intervention for adrenal tumors?

Accepted Answer

Metastatic disease

Answer

Benign histology

Answer

Small size (<4 cm)

Answer

Incidental discovery

Question 44

Which of the following is a potential complication associated with adrenalectomy?

Accepted Answer

Addison's disease

Answer

Pheochromocytoma crisis

Answer

Hyperthyroidism

Answer

Cushing's syndrome

Question 45

Which of the following is a characteristic clinical presentation associated with Cushing's syndrome?

Accepted Answer

Moon face

Answer

Bradycardia

Answer

Leg edema

Answer

Jaundice

Question 46

What is the most common cause of primary adrenal insufficiency?

Accepted Answer

Autoimmune adrenalitis

Answer

Trauma

Answer

Infection

Answer

Cancer

Question 47

Which of the following is a potential complication of pheochromocytoma?

Accepted Answer

Hypertensive crisis

Answer

Hypoglycemia

Answer

Heart failure

Answer

Hyponatremia

Question 48

Which medication is commonly used to treat pheochromocytoma?

Accepted Answer

Phenoxybenzamine

Answer

Nifedipine

Answer

Diltiazem

Answer

Metoprolol

Question 49

Which of the following is a recognized risk factor for pheochromocytoma?

Accepted Answer

Multiple endocrine neoplasia type 2 (MEN2)

Answer

Obesity

Answer

Hypertension

Answer

Diabetes mellitus

Question 50

Which adrenal hormone is primarily involved in the body's stress response?

Accepted Answer

Cortisol

Answer

Epinephrine

Answer

Aldosterone

Answer

Dehydroepiandrosterone (DHEA)