Pituitary Disorders USMLE Step 1 Practice Question
A 56-year-old man with known pituitary macroadenoma presents with sudden severe frontal headache, vomiting, diplopia, and confusion. Vital signs show BP 148/92, HR 98, RR 16, temp 37.2°C, SpO2 98%. Examination reveals right ptosis and impaired abduction. MRI demonstrates hemorrhage within the adenoma. Serum sodium is 138 mEq/L. He denies recent head trauma. Which of the following best explains his acute deterioration?
Answer choices
- AHemorrhagic infarction of a pituitary adenomaCorrect answer
- BSubarachnoid hemorrhage from a berry aneurysm
- CCavernous sinus thrombosis from facial infection
- DOsmotic demyelination syndrome
- EAcute bacterial meningitis
- FIschemic stroke involving the middle cerebral artery territory
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