Pathology EMQ template.

Name: Amirthanayagam Anumithra

Theme: Adrenal

OPTION LIST

A	Phaeochromocytoma	I	Adrenal CT Scan
B	Conn’s syndrome	J	Spironolactone
C	Cushing’s syndrome	K	Zona glomerulosa
D	Alpha blockade	L	Zona fasciculata
E	Beta blockade	M	Low dose dexamethasone test
F	Surgery	N	24 hour ambulatory blood pressure
G	Pituitary MRI	O	Aldosterone- renin ratio
H	High dose dexamethasone test	P	Glucose tolerance test

For each scenario below, choose the most appropriate answer from the list above. Each option may be used once, more than once or not at all.

1. What is the first line of treatment in phaeochromocytomas?

2. A 25 year old female patient presents with high levels of aldosterone and low levels of renin. On examination the patient is found to be hypertensive.

3. A 75 year old lady reports to her GP of very frequent panic attacks. She complains of excessive sweating and following investigations, hypertension is detected and raised levels of catecholamines are found in the urine.

4.  A 53 year old male patient presents with constantly high blood pressure. He is an investment banker and initially the elevation is thought to be related to stress. The patient’s Na, K and urea are all normal. His glucose is however taken randomly and is found to be elevated at 7.9mmol/L. What is the first investigation that needs to be carried out in this patient ?

5. Which part of the adrenal cortex produces glucocorticoids in response to the Adrenocorticotrophic hormone ? (ACTH)

ANSWERS

1. D

2. B

3. A

4. N

5. L