Pituitary Gland Pathology MCQs
Pituitary Gland Pathology MCQs
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- 1. Question
A 30-year-old woman presents with oligo/amenorrhea and galactorrhea. What is the likelihood of her having hyperprolactinemia?
CorrectIncorrectConsider the association between oligo/amenorrhea and galactorrhea.
- 2. Question
Which of the following is the first-line therapy for prolactinomas?
CorrectIncorrectLook for the most efficacious and well-tolerated dopamine agonist.
- 3. Question
Which of the following is the most common cause of hyperprolactinemia?
CorrectIncorrectConsider the cause related to medications.
- 4. Question
In a patient with a large macroadenoma and only modestly elevated prolactin levels, what phenomenon should be considered?
CorrectIncorrectThink about the phenomenon caused by saturation of antibodies in a two-site immunoassay.
- 5. Question
What is the recommended course of action for pregnant patients with macroprolactinomas?
CorrectIncorrectConsider the importance of monitoring visual field during pregnancy.
- 6. Question
A 35-year-old female presents with galactorrhea and amenorrhea. What is the most appropriate initial laboratory evaluation for this patient?
CorrectIncorrectThe initial laboratory evaluation should help identify common causes of hyperprolactinemia.
- 7. Question
What is the primary treatment of choice for most symptomatic patients with microadenomas or idiopathic hyperprolactinemia?
CorrectIncorrectThe treatment should normalize prolactin levels, correct amenorrhea-galactorrhea, and decrease tumor size.
- 8. Question
Which of the following is a rare but significant side-effect of dopamine agonist treatment?
CorrectIncorrectThis side-effect is due to the rapid shrinkage of a large prolactinoma allowing CSF to escape.
- 9. Question
In patients with macroprolactinomas and normal to modestly elevated prolactin levels, why should prolactin levels be remeasured at 1:10 or 1:100 dilution?
CorrectIncorrectThe “hook effect” is due to saturation of the assay antibodies and can lead to falsely normal or modestly elevated prolactin levels.
- 10. Question
A 35-year-old female patient presents with amenorrhea and galactorrhea. Which of the following tests is NOT part of the initial laboratory evaluation for hyperprolactinemia?
CorrectIncorrectConsider which test is unrelated to the causes of hyperprolactinemia.
- 11. Question
Which of the following can cause a false elevation of prolactin levels in serum due to high molecular weight variants of prolactin with diminished biologic potency?
CorrectIncorrectConsider which option refers to a high molecular weight variant of prolactin.
- 12. Question
In patients with prolactinomas and normal to modestly elevated prolactin levels, which phenomenon might be responsible for the misleading results?
CorrectIncorrectConsider which effect is related to saturation of the assay antibodies in prolactin assays.
- 13. Question
What is the first-line treatment for most symptomatic patients with prolactinomas?
CorrectIncorrect - 14. Question
A 35-year-old female patient presents with amenorrhea and galactorrhea. Which of the following tests is NOT part of the initial laboratory evaluation for hyperprolactinemia?
CorrectIncorrectConsider which test is unrelated to the causes of hyperprolactinemia.
- 15. Question
Which of the following can cause a false elevation of prolactin levels in serum due to high molecular weight variants of prolactin with diminished biologic potency?
CorrectIncorrectConsider which option refers to a high molecular weight variant of prolactin.
- 16. Question
In patients with prolactinomas and normal to modestly elevated prolactin levels, which phenomenon might be responsible for the misleading results?
CorrectIncorrectConsider which effect is related to saturation of the assay antibodies in prolactin assays.
- 17. Question
What is the first-line treatment for most symptomatic patients with prolactinomas?
CorrectIncorrect - 18. Question
A 45-year-old male with inadequately treated hypertension presents with a sudden severe headache, vomiting, and visual defects. Which of the following conditions is most likely responsible for his symptoms?
CorrectIncorrectConsider the symptom constellation in the context of the patient's medical history.
- 19. Question
A 38-year-old female with a history of non-functioning pituitary macroadenoma presents with sudden headache, vomiting, and decreased visual acuity. Which factor in her medical history increases her risk of pituitary apoplexy?
CorrectIncorrectConsider the predisposing conditions associated with pituitary apoplexy.
- 20. Question
In patients with pituitary apoplexy, what is the most common presenting symptom?
CorrectIncorrect - 21. Question
Which of the following drugs has been associated with an increased risk of pituitary apoplexy?
CorrectIncorrect - 22. Question
A 55-year-old female with a history of pituitary tumor presents with a severe headache, vomiting, and visual disturbances. Which radiologic test is the most appropriate for the diagnosis of pituitary apoplexy?
CorrectIncorrectConsider the recommended radiologic tests for pituitary apoplexy diagnosis.
- 23. Question
A 60-year-old male with suspected pituitary apoplexy has a random cortisol level of 4 ug/dl. What does this result suggest?
CorrectIncorrectConsider the expected results of cortisol in patients with pituitary apoplexy.
- 24. Question
Which condition is the major source of mortality associated with pituitary apoplexy?
CorrectIncorrectConsider the endocrine dysfunctions in patients with pituitary apoplexy.
- 25. Question
A patient with pituitary apoplexy and significant neuro-ophthalmic signs is being managed in the hospital. What is the most appropriate initial treatment for this patient?
CorrectIncorrectConsider the immediate treatment priority for pituitary apoplexy patients.
- 26. Question
A 50-year-old patient presents with headache, vomiting, and vision defects. Which of the following is NOT part of the Apoplexy Triad?
CorrectIncorrectConsider the three main symptoms that make up the Apoplexy Triad.
- 27. Question
In patients with pituitary apoplexy, what percentage of patients is likely to have true apoplexy (the constellation of symptoms)?
CorrectIncorrectConsider the incidence of true apoplexy among pituitary tumor patients.
- 28. Question
Which of the following conditions is a predisposing factor for pituitary apoplexy?
CorrectIncorrectConsider the conditions that increase the risk of pituitary apoplexy.
- 29. Question
What is the main cause of the symptoms and consequences of pituitary apoplexy?
CorrectIncorrectConsider the primary factor responsible for the symptoms and consequences of pituitary apoplexy.
- 30. Question
A 45-year-old patient presents with fatigue, decreased muscle mass, and decreased libido. Which hormone deficiency should be suspected in this patient?
CorrectIncorrectConsider the hormone deficiency that affects muscle mass and libido.
- 31. Question
A patient with panhypopituitarism presents with amenorrhea and slightly elevated prolactin levels. What is the likely cause of these symptoms?
CorrectIncorrectConsider the effect of pituitary stalk damage on prolactin levels.
- 32. Question
Which of the following tests is the screening test of choice to rule out adrenal insufficiency?
CorrectIncorrectConsider the most commonly used test for adrenal insufficiency screening.
- 33. Question
A patient presents with polyuria, polydipsia, hypernatremia, and low urine osmolarity. What is the likely pituitary-related cause of these symptoms?
CorrectIncorrectConsider the pituitary-related condition that causes excessive urination and thirst.
- 34. Question
Which of the following is NOT a cause of acquired hypopituitarism?
CorrectIncorrect - 35. Question
In a patient with hypopituitarism, which of the following symptoms is associated with a deficiency in GH/IGF-1?
CorrectIncorrectConsider the hormone deficiency that affects energy levels.
- 36. Question
Which of the following pituitary hormone deficiencies can cause hyponatremia?
CorrectIncorrectConsider the hormone deficiency that affects sodium balance.
- 37. Question
In patients with hypopituitarism, the order of loss of hormonal function tends to preserve the most crucial hormones for survival. Which hormone deficiency usually manifests first?
CorrectIncorrectConsider the hormone deficiency that is least crucial for survival.
- 38. Question
Which of the following is a potential cause of hypopituitarism due to hypothalamic disease?
CorrectIncorrectConsider a tumor that can affect the hypothalamus.
- 39. Question
A 56-year-old male patient with a history of unexplained fatigue presents with low morning cortisol levels. Which test should be performed to confirm ACTH deficiency in this patient?
CorrectIncorrectConsider the test that measures cortisol response to a stressor.
- 40. Question
A 48-year-old postmenopausal woman is suspected of having hypopituitarism. Which hormone level can be a sensitive test to screen for hypopituitarism in this patient?
CorrectIncorrectConsider a gonadal hormone that can be sensitive in postmenopausal women.
- 41. Question
In a patient with secondary hypothyroidism, which of the following hormone levels should not be followed to titrate thyroid replacement therapy?
CorrectIncorrectConsider the hormone that is not useful in secondary hypothyroidism.
- 42. Question
A 45-year-old male patient with newly diagnosed hypopituitarism is being started on hormone replacement therapy. Which hormone should be replaced first to avoid a potentially life-threatening condition?
CorrectIncorrectConsider the hormone replacement with the most critical metabolic function.
- 43. Question
A 35-year-old woman presents with excessive thirst and frequent urination. She reports an average daily urine output of more than 4 liters. What is the most likely diagnosis?
CorrectIncorrectExcessive thirst and frequent urination are associated with a lack of production or action of vasopressin.
- 44. Question
Which hormone primarily regulates renal water excretion and is involved in the pathophysiology of DI?
CorrectIncorrectThis hormone increases the expression of Aquaporin 2 in the renal collecting duct.
- 45. Question
A 40-year-old man with a history of traumatic brain injury presents with polyuria and polydipsia. Which form of DI is most likely in this case?
CorrectIncorrectThis form of DI can occur in patients with traumatic brain injury.
- 46. Question
In the case of X-linked familial nephrogenic DI, which gene mutation is primarily responsible?
CorrectIncorrectThis gene is responsible for the AVP receptor on the interstitial surface of target cells in the distal nephron.
- 47. Question
A patient with DI is found to have a pituitary mass during imaging studies. Which diagnosis should be considered other than pituitary adenoma?
CorrectIncorrectThis tumor is a non-pituitary adenoma that can be associated with DI.
- 48. Question
Which of the following is a cause of secondary/acquired hypothalamic DI?
CorrectIncorrectThis cause of DI is an inflammatory condition.
- 49. Question
A patient with DI and a history of long-term lithium use is suspected to have nephrogenic DI. What is the most likely reason for this patient's condition?
CorrectIncorrectThis drug is known to cause toxic renal tubulopathy.
- 50. Question
Which of the following is a characteristic of the antidiuretic phase seen in some patients following pituitary stalk trauma?
CorrectIncorrectThis phase is suggestive of AVP excess.
