Pituitary Disorders USMLE Step 1 Practice Question
A 42-year-old woman presents with progressive frontal headaches and amenorrhea for 8 months. Vital signs show BP 128/82, HR 78, RR 16, temperature 37°C, SpO2 98%. Physical examination reveals bitemporal hemianopsia; thyroid examination is normal. Serum prolactin is 89 ng/mL with normal TSH (2.1 mIU/L). MRI demonstrates a 2.2 cm intrasellar mass compressing the optic chiasm. Which of the following is the most appropriate initial management?
Answer choices
- AWatchful waiting with repeat MRI in 6 months
- BGnRH agonist therapy
- CExternal beam radiation therapy
- DImmediate transsphenoidal surgery
- EDopamine agonist therapy (bromocriptine or cabergoline)Correct answer
- FLevothyroxine replacement therapy
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