Prolactin & Gonadotropins (Anterior Pituitary)
A woman presents with amenorrhea and galactorrhea. Prolactin is mildly elevated. MRI shows a 6 mm pituitary lesion. Most likely diagnosis?
What is a microprolactinoma?
Adult patient with enlarged hands, coarsened facial features, and hypertension likely has:
What is acromegaly?
Patient presents with central obesity, buffalo hump, purple striae, and easy bruising. Elevated 24-hour urinary free cortisol. Likely source?
What is ACTH-producing pituitary adenoma (Cushing disease)?
Patient presents with polyuria (8 L/day) and dilute urine. Na⁺ = 148 mmol/L. Diagnosis?
What is central diabetes insipidus?
Ischemic necrosis of the pituitary after postpartum hemorrhage is called
What is Sheehan syndrome?
A man with macroadenoma presents with low libido and infertility. LH and FSH are low. Testosterone is low. What explains the gonadal dysfunction?
What is hypogonadotropic hypogonadism due to mass effect?
Which test is most sensitive for diagnosing acromegaly?
What is oral glucose suppression test for GH?
Secondary adrenal insufficiency with low cortisol and preserved aldosterone
What is ACTH deficiency?
Treatment of central diabetes insipidus is:
What is desmopressin (DDAVP)?
Postpartum woman develops hypopituitarism. MRI shows enlarged pituitary with homogeneous enhancement. Likely diagnosis?
What is lymphocytic hypophysitis?
This syndrome involves pituitary tumors, pancreatic endocrine tumors, and parathyroid hyperplasia, often causing hyperprolactinemia:
What is MEN1 (Multiple Endocrine Neoplasia type 1)?
This cardiovascular complication is the leading cause of death in acromegaly:
What is hypertrophic cardiomyopathy/heart failure?
High-dose dexamethasone suppresses cortisol by >50%. Interpretation?
What is pituitary-dependent Cushing disease?
This syndrome of excessive ADH causes hyponatremia without edema, often drug-induced or CNS-related:
What is SIADH?
A patient presents with bitemporal hemianopia and headaches. MRI shows a sellar mass with calcifications. Most likely tumor?
What is craniopharyngioma?
A woman with secondary amenorrhea has prolactin of 150 ng/mL. MRI is normal. Next step?
What is evaluate for hypothyroidism and medications (dopamine antagonists)?
First-line treatment for a GH-secreting pituitary adenoma is:
What is transsphenoidal surgery?
Preferred initial test for suspected secondary adrenal insufficiency?
What is morning serum cortisol ± ACTH stimulation test?
Differentiating central vs nephrogenic diabetes insipidus involves:
What is water deprivation test followed by desmopressin challenge?
Hemochromatosis can lead to hypopituitarism due to deposition of iron primarily affecting this anterior pituitary function:
What is gonadotropin secretion (leading to hypogonadism)?
A pituitary tumor stains positive for alpha-subunit and TSH, but T3/T4 levels are mildly elevated. The patient has thyrotoxicosis. The most likely tumor is:
What is a TSH-secreting pituitary adenoma?
A patient with gigantism shows persistently elevated IGF-1 despite surgery. Next step?
What is medical therapy with somatostatin analogs (octreotide)?
After bilateral adrenalectomy for Cushing disease, rapid pituitary tumor growth occurs. Name this syndrome.
What is Nelson syndrome?
This lab finding helps distinguish SIADH from primary polydipsia: urine osmolality is:
What is >100 mOsm/kg ?
A patient with a sellar mass has hyperprolactinemia (~60 ng/mL) due to impaired dopamine delivery rather than a prolactin-secreting tumor.
What is the stalk effect?