A 52-year-old woman with a pituitary macroadenoma has weakness, double vision and headache. BP 74/48. A CT head is ordered. While waiting for the result, what is the best management?
سؤال مجاني 1 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: A. 0.9% normal saline with stress-dose hydrocortisone
Known macroadenoma + headache, diplopia and shock (BP 74/48) = pituitary apoplexy with acute adrenal insufficiency. Treatment must not wait for imaging: immediate IV hydrocortisone plus fluid resuscitation with 0.9% saline.
- B gives steroids but ignores the hypotension (no fluids); C and D are unsafe in an endocrine emergency.
ليش كل خيار صح أو غلط
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A
ليش صح
Pituitary apoplexy with shock needs immediate IV hydrocortisone plus fluid resuscitation for the hypotension, without waiting for imaging.
✓ Pituitary summary.pdf · p. 7 -
B
ليش غلط
Steroids are right but incomplete: the hypotension also needs fluid resuscitation, and treatment should not wait for the MRI.
✓ Pituitary summary.pdf · p. 7 -
C
ليش غلط
With BP 74/48 this is an adrenal crisis, which can be life-threatening and needs hydrocortisone immediately, not outpatient follow-up.
✓ Adrenal disorders (2).pdf · p. 6 -
D
ليش غلط
Oral fluids and analgesics do not treat adrenal crisis; it needs high-dose IV hydrocortisone and IV normal saline for the hypotension.
✓ Adrenal disorders (2).pdf · p. 6
- المصدر
- Pituitary summary.pdf · p. 7
Adrenal disorders (2).pdf · p. 6 - المحاضرة
- Pituitary Disorders · Endocrinology · Module B
- ظهر في
- MED42 ♂ EOM B