Pituitary Disorders USMLE Step 1 Practice Question
A 34-year-old woman at 8 weeks gestation presents to the obstetric clinic with a known prolactinoma diagnosed 2 years ago, previously treated with bromocriptine resulting in tumor shrinkage to 8 mm on MRI. She discontinued bromocriptine upon conception. Vital signs are stable (BP 118/76, HR 82, RR 16), and she denies visual changes or headaches. Serum prolactin is mildly elevated at 68 ng/mL. Which of the following is the most appropriate management strategy?
Answer choices
- APerform MRI with gadolinium to assess tumor size
- BMeasure prolactin levels every 2 weeks throughout pregnancy
- CWithhold all dopamine agonists; they are teratogenic
- DRestart bromocriptine immediately; it is safe in pregnancyCorrect answer
- ESchedule elective delivery at 36 weeks to minimize tumor expansion
- FInitiate cabergoline as it has superior safety profile compared to bromocriptine in pregnancy
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