Prolactin, Acromegaly & Pituitary Adenoma

A 30-year-old female presents with secondary amenorrhea, galactorrhea, and persistent headaches. Initial prolactin levels are significantly elevated. After excluding pregnancy and medication-induced hyperprolactinemia, which of the following is the MOST appropriate next step in evaluating the cause of her symptoms?

A patient is diagnosed with a pituitary macroadenoma causing visual field defects and panhypopituitarism. Which of the following hormonal deficiencies would MOST likely present the GREATEST immediate threat to the patient's life if left untreated?

A researcher is investigating the regulatory mechanisms of prolactin secretion. Which of the following substances is the PRIMARY inhibitory regulator of prolactin release from the anterior pituitary?

A 45-year-old male presents with progressive acromegaly. Despite undergoing transsphenoidal surgery to remove the pituitary adenoma, his growth hormone (GH) and IGF-1 levels remain elevated. Which of the following represents the MOST appropriate next step in his management?

A patient with known panhypopituitarism is started on hydrocortisone replacement therapy. Which of the following instructions is MOST crucial to provide to the patient regarding their medication?

A 50-year-old male presents with new-onset erectile dysfunction, decreased libido, and fatigue. His lab results show low testosterone, normal to low FSH and LH, and elevated prolactin. After ruling out other causes of hyperprolactinemia, what is the MOST likely underlying etiology for his hormonal abnormalities?

Which of the following mechanisms BEST explains how a non-functioning pituitary adenoma can cause hypopituitarism?

A 32-year-old female with a history of a large pituitary adenoma treated with surgery and radiation presents with persistent headaches, fatigue, and new-onset diabetes insipidus. Which of the following hormonal deficiencies is MOST likely responsible for her diabetes insipidus?

Clinically silent pituitary adenomas, despite often staining positive for Gonadotrophin histologically, typically do not secrete. In the rare instances when they do secrete, what are the potential clinical manifestations observed in premenopausal women?

Panhypopituitarism is characterized by a deficiency in most or all of the hormones secreted by the pituitary gland. Which of the following combinations represents the most clinically relevant anterior pituitary hormone deficiencies associated with this condition?

Pituitary macroadenomas are often associated with hypopituitarism due to the pressure they exert on pituitary cells. Besides pituitary adenomas, which of the following factors can lead to pituitary hormone deficiency?

Sheehan's syndrome is a specific cause of panhypopituitarism that results from ischemic necrosis of the pituitary gland. What is the primary event that leads to this ischemic necrosis in Sheehan's syndrome?

A patient presents with decreased muscle mass, increased fat mass, and decreased bone mineral density. Based on the information provided, which of the following hormonal deficiencies is MOST likely contributing to these signs and symptoms?

A female patient is experiencing a notable decrease in lactation following childbirth. Which hormonal deficiency is most likely the primary cause of this clinical manifestation?

In cases of ACTH deficiency leading to secondary adrenal insufficiency, the clinical presentation is primarily due to a lack of what hormone?

Secondary adrenal insufficiency results from a deficiency in ACTH, impacting the adrenal gland's ability to produce cortisol and adrenal androgens. How does the clinical presentation of secondary adrenal insufficiency MOST distinctly differ from that of primary adrenal failure (Addison's Disease)?

A patient presents with fatigue, anorexia, and abdominal pain. Lab results reveal hyponatremia and hypoglycemia. Which hormonal deficiency is MOST likely causing these symptoms?

A patient with known secondary adrenal insufficiency is admitted to the hospital with severe hypotension and dehydration. What is the MOST likely cause of this adrenal crisis?

A male patient reports decreased libido, erectile dysfunction, and fatigue. Which hormonal deficiency is MOST likely responsible for these symptoms?

Which of the following signs is MOST indicative of adrenal crisis, a life-threatening complication of adrenal insufficiency?

A young female patient presents with primary amenorrhea. Which of the following deficiencies could MOST likely be the cause?

A 45-year-old male presents with fatigue, muscle weakness, and joint pain. His blood tests reveal low cortisol levels. Further investigation reveals that the issue originates in the pituitary gland. Which of the following is the MOST likely diagnosis?

A patient with a history of pituitary adenoma develops sudden, severe headache, visual disturbances, and cardiovascular collapse. Which of the following conditions is the MOST likely cause of their current presentation?

Which of the following conditions is LEAST likely to be mistaken for gonadotrophin deficiency in the differential diagnosis of fatigue and low libido in a young male?

A patient presents with a pituitary adenoma alongside pancreatic endocrine and parathyroid tumors. Which genetic syndrome is most likely associated with this presentation?

A patient with known acromegaly exhibits persistent headaches and blurred vision. Which of the following additional findings would most strongly suggest macroadenoma-related compression of the optic chiasm?

A 45-year-old male presents with decreased libido, erectile dysfunction, and is found to have elevated prolactin levels. Which of the following etiologies would be LEAST likely to be the primary cause of his hyperprolactinemia?

A 32-year-old female presents with secondary amenorrhea and galactorrhea. Her prolactin level is significantly elevated. After ruling out pregnancy and medication use, what is the next most appropriate step in evaluating the cause of her hyperprolactinemia?

In the diagnosis of acromegaly, which of the following test results would provide the strongest evidence supporting the diagnosis?

A researcher is studying the mechanism of action of dopamine on prolactin secretion. Which of the following statements BEST describes the role of dopamine in regulating prolactin secretion?

A patient presents with visual disturbances, headaches, and symptoms of hypopituitarism. Imaging reveals a lesion in the sella turcica. Which of the following lesions, based on its origin, would be LEAST likely to cause hypersecretion of a pituitary hormone?

A patient is diagnosed with acromegaly. Besides elevated IGF-1 levels, what other diagnostic finding is crucial for confirming that the source of the excess growth hormone is a pituitary adenoma rather than ectopic production?

A 50-year-old male presents with symptoms suggestive of acromegaly. His initial IGF-1 level is borderline elevated. Which of the following is the MOST appropriate next step to confirm the diagnosis?

A patient with a known prolactinoma is being treated with a dopamine agonist. Which of the following clinical findings would warrant the MOST urgent evaluation and potential adjustment of their treatment?

A patient with long-standing, untreated acromegaly is MOST at risk for developing which of the following complications?

Why would the presence of galactorrhea be a less common symptom in men with prolactinomas compared to premenopausal women?

Which of the following findings would be most suggestive of a pituitary stalk compression interfering with dopamine delivery, rather than a primary prolactinoma?

A patient with acromegaly undergoes transsphenoidal surgery for removal of a somatotroph adenoma. Postoperatively, their IGF-1 levels normalize, but they develop persistent diabetes insipidus. What is the most likely cause of this new complication?

What is the MOST likely long-term consequence of untreated acromegaly that directly contributes to increased mortality?

A patient presents with symptoms suggestive of acromegaly. Which of the following diagnostic findings would be most indicative of this condition, considering the complexities of hormone regulation and feedback?

A young female patient is diagnosed with a prolactinoma. Considering the nuances of dopamine agonist therapy, which of the following statements represents the most comprehensive understanding of its mechanism and expected outcomes?

In differentiating between Cushing's disease and ectopic ACTH production as causes of Cushing's syndrome, which of the following clinical and biochemical findings would most strongly suggest ectopic ACTH production?

A 5-year-old child is diagnosed with Prader-Willi syndrome. Considering the endocrine abnormalities associated with this genetic disorder, which of the following hormonal deficiencies is most commonly observed and requires careful monitoring and management?

A patient with known Hashimoto's thyroiditis presents with worsening fatigue, weight gain, and cold intolerance despite being on a stable dose of levothyroxine for several years. Which of the following factors should be most carefully evaluated to optimize their thyroid hormone replacement therapy?

What is the primary mechanism of action of cabergoline in the treatment of prolactinomas?

A patient with Cushing's disease undergoes pituitary surgery, but post-operative cortisol levels remain elevated. Which of the following medical therapies would be most appropriate to consider next, taking into account the various mechanisms by which hypercortisolism can be managed medically?

In the management of acromegaly, somatostatin receptor ligands (SRLs) are frequently used when surgery is not curative. Which of the following mechanisms underlies the therapeutic effect of SRLs in this context?

A patient is diagnosed with central diabetes insipidus following a traumatic brain injury. Considering the complexity of vasopressin regulation, which of the following hormonal profiles would be most consistent with this diagnosis?

A patient is suspected of having autonomous cortisol secretion from an adrenal adenoma. Which of the following test results would provide the strongest evidence for this diagnosis, reflecting the disruption of normal hypothalamic-pituitary-adrenal (HPA) axis feedback?

Pituitary Hormone Excess

Pituitary Hormone Deficiency

Cardinal Symptoms

Pathophysiology

Differential Diagnosis

Adenohypophysis

Neurohypophysis

Prolactin Levels

Pituitary adenomas

Hypopituitarism

Panhypopituitarism

ACTH deficiency

Secondary Hypothyroidism

Growth Hormone Deficiency

Sheehan’s syndrome

Hypogonadism

Hypogonadotropic Hypogonadism

Symptoms of ACTH Deficiency

Adrenal Crisis

Gonadotrophin Deficiency Symptoms

Primary vs Secondary Adrenal Insufficiency

Signs of Low Cortisol Levels

Differentials for Deficiencies

Prolactinoma

Hypersecretion

Hyposecretion

Somatotroph Adenoma

Acromegaly

Gigantism

IGF-1

Cortisol and ACTH

Prolactin Effects

Thyrotroph Adenoma

Diabetes Mellitus

Carpal Tunnel Syndrome

Hyperprolactinemia

Pressure Symptoms

Mortality Increase

Prader-Willi Syndrome

Cushing's Disease

Gonadotrophin Disorders

Malnutrition

Dopamine Agonists

Somatostatin Receptor Ligands

ACTH