A 33-year-old woman has Cushing syndrome with HTN, diabetes, hirsutism and purple striae. 8 am cortisol high, ACTH 129 (high), urine free cortisol high. MRI shows a 6 mm pituitary adenoma. What is the appropriate treatment?
سؤال مجاني 6 من 10 اليوم · اشترك وكمّل بدون حد
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الإجابة والشرح
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الإجابة: C. Transsphenoidal surgery
High cortisol with high ACTH and a 6 mm pituitary adenoma = Cushing disease. First-line treatment is transsphenoidal resection of the adenoma. Cabergoline is for prolactinomas. Radiation is reserved for failed surgery. Bilateral adrenalectomy can cause Nelson syndrome (growth of the existing ACTH adenoma).
ليش كل خيار صح أو غلط
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A
ليش غلط
Cabergoline (a dopamine agonist) is for a prolactinoma; this is an ACTH-secreting pituitary adenoma (high ACTH with high cortisol).
✓ Step Up To Medicine 6th Edition 2024 (Pituitary).pdf · p. 3 -
B
ليش غلط
The notes make surgery the treatment of choice for operable Cushing disease; pituitary radiation is mentioned only under Nelson syndrome.
✓ Adrenal disorders (2).pdf · p. 10 -
C
ليش صح
Cushing disease (ACTH-producing pituitary tumour) is treated with transsphenoidal resection of the adenoma, which is usually safe and effective.
✓ Step Up To Medicine 6th Edition 2024 (Adrenal).pdf · p. 4 -
D
ليش غلط
Bilateral adrenalectomy can lead to Nelson syndrome (enlargement of an undiscovered pituitary adenoma), so it does not treat the pituitary source.
✓ Adrenal disorders (2).pdf · p. 10
- المصدر
- Step Up To Medicine 6th Edition 2024 (Adrenal).pdf · p. 4
Adrenal disorders (2).pdf · p. 10 - المحاضرة
- Cushing's Syndrome · Endocrinology · Module B
- ظهر في
- MED41 ♀ EOM B