Pituitary Disorders USMLE Step 1 Practice Question
A 42-year-old woman presents with progressive frontal headaches, bitemporal hemianopsia, and secondary amenorrhea for 8 months. Vital signs: BP 128/82 mmHg, HR 76/min, RR 14/min, Temp 37°C. Laboratory studies reveal elevated serum prolactin (150 ng/mL), normal TSH (2.1 mIU/L), and normal cortisol. MRI demonstrates a 2 cm sellar mass with suprasellar extension. Visual field testing confirms bitemporal defect. No galactorrhea is noted. Which diagnosis best explains these findings?
Answer choices
- AHypothyroidism with elevated TRH-induced prolactin
- BAcromegaly with secondary hypogonadism
- CNon-functioning pituitary adenoma with mass effect
- DCushing disease with amenorrhea
- EProlactin-secreting adenomaCorrect answer
- FCraniopharyngioma with hyperprolactinemia secondary to pituitary stalk compression
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