Pituitary Disorders USMLE Step 1 Practice Question
A 55-year-old woman with newly diagnosed acromegaly presents with hypertension (BP 152/94 mmHg), heart rate 88/min, and progressive coarsening of facial features over 2 years. MRI shows a 3 cm pituitary adenoma. Preoperative labs reveal IGF-1 1250 ng/mL, random GH 18 ng/mL, and normal prolactin. She denies visual field changes. She is not currently taking medications. She is counseled regarding transsphenoidal surgery and asks about cure rates. Which outcome best represents expected surgical success?
Answer choices
- AHigher remission rates with macroadenomas than microadenomas
- BBiochemical remission in >90% of all acromegaly cases regardless of tumor size
- CBiochemical remission in approximately 50% of macroadenoma casesCorrect answer
- DPermanent cure in 100% of patients with effective surgery
- ENo role for surgery; medical therapy alone is definitive treatment
- FPreoperative somatostatin analog therapy improving surgical cure rates
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