Pituitary Disorders USMLE Step 1 Practice Question
A 52-year-old woman with sudden onset severe headache, neck stiffness, and visual disturbance is found to have a sellar mass on MRI with evidence of hemorrhage. Her serum sodium is 125 mEq/L. Vital signs show hypotension (90/55 mmHg) and tachycardia. Which of the following is the most appropriate immediate management?
Answer choices
- AHormone replacement therapy only
- BDopamine agonist initiation
- CObservation with serial MRI imaging
- DFluid restriction and hypertonic saline
- EHigh-dose corticosteroids and emergent transsphenoidal decompressionCorrect answer
- FImmediate neurosurgical craniotomy with frontal approach and gradual sodium correction
See the full explanation
Get the correct-answer rationale, why each distractor is wrong, the underlying mechanism, and high-yield associations — plus adaptive practice that targets your weak areas — with a free MedBoardPRO account.