Organ System Pathology USMLE Step 1 Practice Question
A 56-year-old man with a known pituitary macroadenoma presents with sudden severe frontal headache, vomiting, diplopia, and confusion. Vital signs show BP 156/92 mmHg, HR 78/min, RR 16/min, temperature 37.2°C. Physical examination reveals right ptosis and impaired abduction. Brain MRI demonstrates hemorrhage within the adenoma with mass effect on the cavernous sinus. Serum sodium is 138 mEq/L. Which complication best explains his acute neurologic deterioration?
Answer choices
- ASubarachnoid hemorrhage from a berry aneurysm
- BCavernous sinus thrombosis from facial infection
- CAcute bacterial meningitis
- DHemorrhagic infarction of a pituitary adenomaCorrect answer
- EOsmotic demyelination syndrome
- FAcute angle-closure glaucoma with optic nerve compression
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