Penny's Book Chapter 8- The Adrenal Glands Review Questions

a. Adrenal hemorrhage

1. An abdominal sonogram is requested for a newborn in the intensive care unit. The newborn suffered from brief anoxia at birth and is now experiencing jaundice. Superior to the right kidney, a triangle-shaped, heterogeneous mass is visualized. What is the most likely diagnosis? a. Adrenal hemorrhage b. Adrenal adenoma c. Pheochromocytoma d. Cushing syndrome

b. hematoma

13. A localized collection of blood describes a: a. hemangioma b. hematoma c. hypertoma d. hydrocele

c. suprarenal arteries

15. The arterial blood supply to the adrenal glands is accomplished by means of the: a. celiac trunk b. subphrenic arteries c. suprarenal arteries d. superior mesenteric artery

a. Addison disease

16. Bronzing of the skin is a clinical finding associated with: a. Addison disease b. Cushing disease c. Cushing syndrome d. Conn syndrome

d. adrenaline

19. The adrenal cortex produces all of the following except: a. cortisol b. androgens c. aldosterone d. adrenaline

c. Norepinephrine

20. Which of the following is produced by the adrenal medulla? a. Cortisol b. Aldosterone c. Norepinephrine d. Androgens

c. Hyponatremia

21. What is the term for low levels of sodium in the blood? a. Hypokalemia b. Hypopigmentation c. Hyponatremia d. Hypodisuria

a. IVC

26. The right suprarenal vein drains directly into the: a. IVC b. abdominal aorta c. celiac trunk d. left renal vein

b. heterogeneous mass with calcifications

32. The most common sonographic appearance of a neuroblastoma is: a. hyperechoic mass b. heterogeneous mass with calcifications c. anechoic mass d. hypoechoic mass

a. Zona pellucida

57. Which of the following is not a zone of the adrenal cortex? a. Zona pellucida b. Zona glomerulosa c. Zona fasciculata d. Zona reticularis

d. left renal vein

8. The left suprarenal vein drains directly into the: a. IVC b. abdominal aorta c. celiac trunk d. left renal vein

b. high levels of cortisol

9. Conn syndrome results from: a. low levels of cortisol b. high levels of cortisol c. high levels of aldosterone d. low levels of epinephrine

b. decrease

10. With active internal hemorrhage, the patient's hematocrit will: a. increase b. decrease c. become stable d. not change

d. Hypercortisolism

11. Which of the following would result in a buffalo hump and moon-shaped face? a. Conn syndrome b. Addison disease c. Androgenism d. Hypercortisolism

a. Endocrine glands

12. Which types of glands release their hormones directly into the bloodstream? a. Endocrine glands b. Exocrine glands

a. Anterior pituitary gland tumor

14. What is the cause of Cushing disease? a. Anterior pituitary gland tumor b. Adrenal hemorrhage c. Neuroblastoma d. Hyperaldosteronism

b. Addison disease

18. Which of the following is also referred to as primary adrenocortical insufficiency? a. Conn syndrome b. Addison disease c. Cushing disease d. Congenital adrenal hyperplasia

d. thinning arms and legs

2. All of the following are associated with Conn syndrome except: a. adrenal adenoma b. hypertension c. excessive thirst d. thinning arms and legs

a. Epinephrine and norepinephrine

22. Which of the following hormones are responsible for the flight-or-fight response? a. Epinephrine and norepinephrine b. Cortisol and androgens c. Cortisol and aldosterone d. ACTH and aldosterone

d. Addison disease

23. Which of the following is associated with hyponatremia? a. Cushing syndrome b. Conn syndrome c. Pheochromocytoma d. Addison disease

c. Posterior and lateral to the IVC

24. Which of the following best describes the location of the right adrenal gland? a. Posterior and lateral to the pancreas b. Medial to the lower pole of the right kidney c. Posterior and lateral to the IVC d. Medial to the crus of the diaphragm

d. adrenal cyst

25. Upon sonographic examination of the right upper quadrant in a 32-year-old female patient complaining of generalized abdominal pain, an anechoic mass with posterior enhancement superior and medial to the upper pole of the right kidney is visualized. This most likely represents a(n): a. adrenal metastatic lesion b. pheochromocytoma c. neuroblastoma d. adrenal cyst

d. pheochromocytoma

27. The adrenal mass often associated with uncontrollable hypertension, tachycardia, and tremors is the: a. neuroblastoma b. adrenal hematoma c. oncocytoma d. pheochromocytoma

c. adrenal adenoma

28. A 45-year-old obese woman with thin arms and legs, hypertension, and severe fatigue presents to the ultrasound department for an abdominal sonogram. Based on these clinical findings, the sonographer should evaluate the adrenal glands closely for signs of: a. Addison cyst b. adrenal hemorrhage c. adrenal adenoma d. neuroblastoma

a. hyperechoic mass

29. The most common sonographic appearance of a pheochromocytoma is a(n): a. hyperechoic mass b. hypoechoic mass c. anechoic mass d. complex mass

a. Hematocrit

3. When internal bleeding is suspected, what laboratory value is most useful for a sonographer to evaluate? a. Hematocrit b. Blood urea nitrogen c. Androgenic hormone d. Alkaline phosphatase

d. neuroblastoma

30. The most common, extracranial, malignant mass in children is the: a. hepatoblastoma b. hypernephroma c. pheochromocytoma d. neuroblastoma

b. Conn syndrome

31. Which of the following is associated with hypernatremia? a. Cushing syndrome b. Conn syndrome c. Pheochromocytoma d. Addison disease

d. 5 years

33. The neuroblastoma typically presents before the age of: a. 1 year b. 2 years c. 4 years d. 5 years

c. Aldosterone

34. Which hormone is responsible for regulating blood pressure by controlling the amounts of sodium and water in the body? a. Epinephrine b. Cortisol c. Aldosterone d. ACTH

d. ACTH

35. Which hormone, secreted by the anterior pituitary gland, controls the release of hormones by the adrenal glands? a. Epinephrine b. Cortisol c. Aldosterone d. ACTH

b. neuroblastoma

36. All of the following are most likely a benign adrenal mass except: a. adrenal adenoma b. neuroblastoma c. pheochromocytoma d. adrenal hematoma

a. bradycardia

37. All of the following are clinical findings of a pheochromocytoma except: a. bradycardia b. uncontrollable hypertension c. excessive sweating d. tremors

a. Androgens

38. Which plays a part in the development of male characteristics? a. Androgens b. Cortisol c. Aldosterone d. Hematocrit

b. Adrenal rests

4. Which of the following mass-like lesions may be associated with congenital adrenal hyperplasia and found within the testes? a. Adrenal adenomas b. Adrenal rests c. Pheochromocytomas d. Neuroblastomas

c. the left adrenal gland is located lateral to the upper pole of the left kidney

40. All of the following are true statements about the adrenal glands except: a. the adrenal glands play an important role in blood pressure regulation b. the adrenal glands are easily identified in the fetus c. the left adrenal gland is located lateral to the upper pole of the left kidney d. the right adrenal gland is located medial to the right lobe of the liver

b. Congenital adrenal hyperplasia

41. Which of the following is associated with a deficiency of cortisol production by the adrenal gland? a. Conn syndrome b. Congenital adrenal hyperplasia c. Adrenocorticotropic deficiency syndrome d. Glucocortical deficiency syndrome

c. Pheochromocytoma

42. Which of the following would be least likely associated with an overproduction of the hormones released by the adrenal cortex? a. Cushing syndrome b. Adrenal adenoma c. Pheochromocytoma d. Conn syndrome

d. Incidentaloma

43. What is the term that may be used for an adrenal mass noted during an abdominal sonogram for unrelated clinical findings? a. Adrenaloma b. Fauxoma c. Corticoma d. Incidentaloma

a. Cortisol

44. Which of the following is a glucocorticoid? a. Cortisol b. Aldosterone c. Epinephrine d. Norepinephrine

c. Neuroblastoma

45. Bone pain and purple skin lesions are clinical findings associated with what adrenal tumor? a. Pheochromocytoma b. Incidentaloma c. Neuroblastoma d. Adrenal adenoma

c. Adrenal adenoma

46. The patient in Figure 8-13 presented to the sonography department with a history of elevated liver function tests. What is the most likely pathology being identified by the curved arrow? a. Adrenal cyst b. Neuroblastoma c. Adrenal adenoma d. Pheochromocytoma

d. Pheochromocytoma

47. The patient in Figure 8-14 is a 36-year-old who presented with a history of anxiety, headaches, and excessive sweating. Based on the clinical history, what is the most likely etiology of the structure identified by the arrowheads in these images? a. Adrenal cyst b. Adrenal rest tumor c. Adrenal hemorrhage d. Pheochromocytoma

a. Conn syndrome

48. Which of the following is associated with excessive urination and hyperkalemia? a. Conn syndrome b. Cushing disease c. Cushing syndrome d. Addison disease

c. Hirsutism

49. Which of the following is defined as excessive hair growth in women in areas where hair growth is normally negligible? a. Hypernatremia b. Hypercortisolism c. Hirsutism d. Addison syndrome

b. Cushing syndrome

5. The syndrome associated with hypertension, hyperglycemia, obesity, and an adrenal mass is: a. Edwards syndrome b. Cushing syndrome c. Juliet syndrome d. Hirschsprung syndrome

c. Cushing syndrome

51. What adrenal disorder is associated with striae of the abdomen? a. Conn syndrome b. Addison disease c. Cushing syndrome d. Adrenocortical syndrome

a. high levels of potassium in the blood

52. Hyperkalemia is defined as: a. high levels of potassium in the blood b. high levels of sodium in the blood c. high levels of nitrogen in the blood d. high levels of aldosterone in the blood

d. Enlargement of the adrenal glands

53. A 27-year-old patient presents to the sonography department with the sudden onset of hypotension, muscle weakness, and elevated liver enzymes. Evidence of hyperpigmentation is also noted. What sonographic finding would be most likely associated with this apparent clinical condition? a. Multiple masses within the adrenal glands b. Atrophy of the adrenal glands c. Bilateral adrenal hemorrhage d. Enlargement of the adrenal glands

b. Neuroblastoma

54. The patient in Figure 8-15 was a 3-year-old girl who complained of abdominal pain and who had recent weight loss. What is the most likely diagnosis for the structure identified by the arrowheads? a. Adrenal adenoma b. Neuroblastoma c. Nephroblastoma d. Primary adrenal adenocarcinoma

a. Adrenal hematoma

55. Figure 8-16 is a longitudinal right upper quadrant image of a newborn who was suffering from anemia, jaundice, and an acute drop in blood pressure. What is the most likely etiology of the structure identified by the red arrows? a. Adrenal hematoma b. Adrenal adenoma c. Neuroblastoma d. Adrenal metastasis

d. Crura of the diaphragm

56. What are the tendinous structures that extend from the diaphragm to the vertebral column? a. Stria of the diaphragm b. Tendonae diaphramae c. Ligamentum diaphragmatum d. Crura of the diaphragm

b. Addison disease

58. Which of the following may also be referred to as chronic primary hypoadrenalism? a. Conn syndrome b. Addison disease c. Cushing disease d. Pheochromocytoma syndrome

b. Striae

59. What is another term for stretch marks? a. Crura b. Striae c. Plicae d. Cilia

b. the adrenal glands are exocrine glands

6. All of the following are true statements about the adrenal glands except: a. the adrenal glands are easily identified in the fetus b. the adrenal glands are exocrine glands c. the adrenal glands are composed of a medulla and cortex d. the adrenal glands may also be referred to as the suprarenal glands

d. Calcified mass that produces acoustic shadowing

60. What is the most likely sonographic appearance of a chronic adrenal hematoma? a. Solid, hypoechoic mass that produces acoustic enhancement b. Anechoic, triangular mass that produces shadowing c. Atrophic adrenal gland surrounded by an anechoic fluid collection d. Calcified mass that produces acoustic shadowing

c. Gerota fascia

7. The adrenal glands are surrounded by a connective tissue capsule called: a. Glisson capsule b. adrenocortical fascia c. Gerota fascia d. Glisson fascia

d. acute drop in hematocrit

17. Hyperfunctioning adrenal adenomas are associated with all of the following except: a. Cushing syndrome b. Conn syndrome c. hypoechoic mass in the area of the adrenal gland d. acute drop in hematocrit

d. suprarenal branches of the celiac trunk

39. The adrenal glands receive a portion of their blood supply from all of the following except the: a. suprarenal branches of the inferior phrenic arteries b. suprarenal branches of the aorta c. suprarenal branches of the renal arteries d. suprarenal branches of the celiac trunk

a. high levels of sodium in the blood

50. Hypernatremia is defined as: a. high levels of sodium in the blood b. high levels of potassium in the blood c. high levels of cortisol in the blood d. high levels of nitrogen in the blood