A 42-year-old woman has fatigue, weight gain and cold intolerance for 6 months and amenorrhoea for 8 months. She has dry skin, bradycardia and delayed relaxation of deep tendon reflexes. MRI shows a 2.5 cm mass compressing the optic chiasm. Labs: TSH low, FT4 low, ACTH low, cortisol low, prolactin slightly high. What is the diagnosis?
سؤال مجاني 5 من 10 اليوم · اشترك وكمّل بدون حد
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الإجابة والشرح
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الإجابة: D. Non-functioning pituitary macroadenoma causing hypopituitarism
A 2.5 cm mass compressing the chiasm with low TSH/FT4 and low ACTH/cortisol plus amenorrhoea = hypopituitarism (secondary hypothyroidism, adrenal insufficiency and hypogonadism). Non-secretory macroadenomas are the most common cause of hypopituitarism in adults; mild prolactin rise is from stalk compression.
- Primary hypothyroidism would have high TSH; prolactinoma gives markedly high prolactin; apoplexy is acute (sudden severe headache), not a 6-month course.
ليش كل خيار صح أو غلط
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A
ليش غلط
Primary hypothyroidism gives a high TSH (feedback); her low TSH with low FT4 fits secondary (pituitary) hypothyroidism.
✓ Endocrine ✳️.pdf · p. 13 -
B
ليش غلط
A mass can raise prolactin just by compressing the pituitary stalk, so a slightly high prolactin does not prove a prolactinoma.
✓ Pituitary disorder.pdf · p. 6 -
C
ليش غلط
Her symptoms built up over months; hypopituitarism from adenomas develops slowly, while apoplexy is the cause that develops rapidly.
✓ Pituitary disorder.pdf · p. 3 -
D
ليش صح
Non-secretory macroadenomas (10 mm or more) are the most common cause of hypopituitarism in adults, and the mass here is 2.5 cm.
✓ Pituitary disorder.pdf · p. 3
- المصدر
- Pituitary disorder.pdf · p. 3
Pituitary disorder.pdf · p. 6 - المحاضرة
- Pituitary Disorders · Endocrinology · Module B
- ظهر في
- MED42 Compre B