Chapter·PathologyEndocrine pathology

Pituitary disordersDownloads

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1

A 28-year-old woman presents to her primary care physician complaining of intense thirst and frequent urination for the past 2 weeks. She says that she constantly feels the urge to drink water and is also going to the bathroom to urinate frequently throughout the day and multiple times at night. She was most recently hospitalized 1 month prior to presentation following a motor vehicle accident in which she suffered severe impact to her head. The physician obtains laboratory tests, with the results shown below: Serum: Na+: 149 mEq/L Cl-: 103 mEq/L K+: 3.5 mEq/L HCO3-: 24 mEq/L BUN: 20 mg/dL Glucose: 105 mg/dL Urine Osm: 250 mOsm/kg The patient’s condition is most likely caused by inadequate hormone secretion from which of the following locations?

AAdrenal cortex

BAnterior pituitary

CPreoptic nucleus of the hypothalamus

DSuprachiasmatic nucleus of the hypothalamus

EPosterior pituitary

2

A 45-year-old woman comes to the physician because of fatigue, irregular menses, and recurrent respiratory infections for the past 6 months. Her blood pressure is 151/82 mm Hg. Physical examination shows a round face, thinning of the skin, and multiple bruises on her arms. Further studies confirm the diagnosis of an ACTH-secreting pituitary adenoma. This patient is at greatest risk for which of the following?

AWeight loss

BEosinophilia

CBitemporal hemianopsia

DHypoglycemia

EPathologic fracture

3

Four months after giving birth, a young woman presents to the hospital complaining of lack of breast milk secretion. The patient complains of constantly feeling tired. Physical exam reveals that she is slightly hypotensive and has lost a significant amount of weight since giving birth. The patient states that she has not experienced menstruation since the birth. Which of the following is likely to have contributed to this patient's presentation?

APrimary empty sella syndrome

BIncreased anterior pituitary perfusion

CObstetric hemorrhage

DPregnancy-induced decrease in anterior pituitary size

EProlactinoma

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