A 29-Year-Old Man Comes to the Office Due to Progressive

question 305

Multiple Choice

A 29-year-old man comes to the office due to progressive headaches, fatigue, and visual disturbances for the past 6 weeks.  He was diagnosed with sarcoidosis a year ago after having a dry cough and hypercalcemia.  The patient's condition was treated with oral glucocorticoid therapy, which was discontinued after 6 months due to improvement in symptoms.  Physical examination reveals bitemporal defects on visual field testing but is otherwise normal.  Laboratory studies again show mild hypercalcemia, but the remainder of the values, including complete blood count, serum glucose, creatinine, and electrolytes, are within normal reference ranges.  MRI of the brain reveals a soft tissue mass involving the hypothalamus and pituitary stalk.  Which of the following pituitary hormones is most likely elevated in this patient?

• A)ACTH
• B)Growth hormone
• C)Prolactin
• D)Thyrotropin
• E)Vasopressin

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Definitions:

Institutionalization

The process of making something a part of an organized system, often referring to the effect of long-term hospital or prison environments on individuals.

Deinstitutionalization

The process of moving mentally ill patients from long-term institutions into community- or family-based care.

Advantages

The benefits or favorable positions gained from a particular situation or action.

Secondary Prevention

Efforts aimed at early detection and prompt intervention to prevent the progression of a disease or injury.