A 48-year-old man has a head MRI showing a 0.9 cm right-sided pituitary adenoma without parasellar extension. He feels well with no visual impairment. BP 137/70, HR 70, normal reflexes. All pituitary hormones are within normal range except cortisol 15.7 (ULN 15) and Na 143 (ULN 142) — both only marginally above. What is the next step in management?
سؤال مجاني 2 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: A. Repeat the MRI in 12 months
A 0.9 cm adenoma is a microadenoma (<10 mm) with no mass effect, no visual loss and no clinically meaningful hormone excess (cortisol and Na only marginally high). The source plan is observation for non-functioning pituitary microadenomas — i.e. repeat imaging later. Microadenomas usually stay the same size or regress.
- Surgery is for GH/ACTH/TSH-secreting tumours, mass effect, visual defects or hypopituitarism; cabergoline is for prolactinoma; radiotherapy is not first-line.
ليش كل خيار صح أو غلط
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A
ليش صح
A small, hormonally quiet pituitary adenoma without symptoms is managed by observation, so repeat imaging is the next step.
✓ RT - Pituitary.pdf · p. 3 -
B
ليش غلط
In Step Up's acromegaly plan, radiation therapy is used only if medical therapy fails after surgery; it is not a first step for an untreated adenoma with no symptoms.
✓ Step Up To Medicine 6th Edition 2024 (Pituitary).pdf · p. 4 -
C
ليش غلط
Surgery is reserved for GH/ACTH/TSH-secreting tumours, mass effect, visual field defects or hypopituitarism; he has none of these.
✓ RT - Pituitary.pdf · p. 3 -
D
ليش غلط
Cabergoline (a dopamine agonist) is for a symptomatic prolactinoma; his hormones are normal and he has no symptoms.
✓ RT - Pituitary.pdf · p. 3
- المصدر
- RT - Pituitary.pdf · p. 3
Step Up To Medicine 6th Edition 2024 (Pituitary).pdf · p. 3 - المحاضرة
- Pituitary Disorders · Endocrinology · Module B
- ظهر في
- MED42 ♂ EOM B