Pituitary Disorders USMLE Step 1 Practice Question
A 62-year-old man with history of pituitary macroadenoma treated with transsphenoidal surgery 3 months ago presents with acute confusion, severe frontal headache, and nuchal rigidity. Vital signs: BP 108/62, HR 102, RR 18, Temp 38.2°C, SpO2 98% on room air. Serum sodium 118 mEq/L. CSF analysis reveals pleocytosis with elevated protein and low glucose. Gram stain and bacterial cultures are pending. He denies photophobia. Which diagnosis best explains his clinical presentation?
Answer choices
- ACentral pontine myelinolysis from rapid sodium correction
- BAcute adrenal crisis from postoperative cortisol deficiency
- CRecurrent pituitary apoplexy
- DPostoperative meningitis with secondary SIADHCorrect answer
- EDiabetes insipidus with dehydration-induced hypernatremia
- FCSF rhinorrhea with ascending bacterial meningitis from nasal flora
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