• Adrenal Incidentaloma:
  • If >4cm, presumed to be malignant and needs further evaluation
  • Need to consider whether it is functioning or not
  
  

  Posted 10/10/16 11:45:56 AM by Adam Faye

• Adrenal Mass - Must rule our Pheochromocytoma
  • Serum Metanephrines have high sensitivity
  • Do NOT start beta Blockers until Pheo is ruled out. Would not use alpha/beta blockers either, because generally block beta receptors more than alpha- leaving unopposed alpha blockade. 
  • Classic story from Pheo- often hear excessive diaphoresis
  
  

  Posted 10/10/16 11:57:25 AM by Adam Faye

• HyperAldo:
  • Generally see hypertension and hypokalemia
  • Labs generally show; suppressed Renin & Aldo >15. Typically Aldo/Renin ratio >20. Usually test AM sample, and have patient off mineralocorticoid receptor antagonists (eg: spironolactone) or ACEi/ARBs.
  • Low K+ can cause aldosterone levels to appear lower
  
  

  Posted 10/10/16 12:01:52 PM by Adam Faye

• **Do NOT biopsy Adrenal Carcinoma, as it can seed other sites***
  • Adjuvant Mitotine for treatment of adrenocrtical carcinoma may prolong recurrence-free survival
  
  

  Posted 10/10/16 01:33:12 PM by Adam Faye

• 25% of one adrenal gland is all that is needed for normal functioning.
  
  

  Posted 10/10/16 01:37:02 PM by Adam Faye

• Primary Aldosteronism Management
  
  

  Posted 10/10/16 02:33:53 PM by Adam Faye

Created by Christopher Kelly

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