Pituitary Disorders USMLE Step 1 Practice Question
A 45-year-old woman presents with progressive frontal headache, bitemporal hemianopsia, and amenorrhea for 8 months. Vital signs show BP 128/82 mmHg, HR 78/min, RR 14/min, temperature 37°C. Serum prolactin is elevated at 185 ng/mL; TSH and cortisol are normal. MRI demonstrates a 2.2 cm sellar mass with optic chiasm compression. Visual acuity remains intact. She takes no hormonal medications. Which of the following is the most appropriate initial management?
Answer choices
- ADopamine agonist therapyCorrect answer
- BCombined hormonal contraceptive therapy
- CTranssphenoidal surgery immediately
- DRadiation therapy
- EBromocriptine followed by surgery in 3 months
- FOctreotide (somatostatin analog) to suppress prolactin secretion
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