Pituitary Disorders USMLE Step 1 Practice Question
A 52-year-old woman presents with acute severe frontal headache, sudden bitemporal hemianopia, and altered mental status. Vital signs reveal BP 88/52 mmHg, HR 118/min, RR 22/min, temp 37.2°C, SpO2 98% on room air. MRI shows a 2.5-cm pituitary mass with hemorrhage and blood-fluid level. Serum sodium is 128 mEq/L. She denies recent head trauma. Which pharmacologic intervention is most immediately indicated?
Answer choices
- AIntravenous insulin
- BOral levothyroxine
- CVasopressin receptor antagonist
- DIntravenous dexamethasoneCorrect answer
- EIntramuscular ACTH
- FIntravenous hypertonic saline
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