Pituitary Disorders USMLE Step 1 Practice Question
A 29-year-old man with type 1 diabetes presents with sudden-onset severe frontal headache, fever (39.2°C), and altered mental status. Vital signs show BP 118/76, HR 104, RR 18, SpO2 98% on room air. Pituitary MRI demonstrates symmetric gland enlargement with homogeneous enhancement. CSF analysis reveals protein 89 mg/dL, glucose 52 mg/dL, and lymphocytic pleocytosis (180 cells/μL). Neck stiffness is absent. Which diagnosis best explains these findings?
Answer choices
- APituitary adenoma with hemorrhage
- BViral encephalitis
- CLymphocytic hypophysitisCorrect answer
- DBacterial meningitis
- ETuberculosis of the pituitary
- FAcute pituitary abscess with pneumococcal infection
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