A 26-year-old woman presents at 4 weeks post partum with headaches, profound weakness, nausea, and vomiting. She had been breast-feeding. Physical examination fi ndings are unremarkable. Magnetic resonance imaging (MRI) of the head shows a sellar mass with suprasellar extension but without chiasmal compression. Laboratory test results (and reference ranges) include the following: serum sodium 125 mEq/L (136–142 mEq/L), serum prolactin 72 ? g/L (4–30 ? g/L), 8 am serum cortisol 3 ? g/dL (5–25 ? g/dL), serum adrenocorticotropic hormone (ACTH) 10 pg/mL (10–60 pg/mL), and normal values for serum free thyroxine and thyrotropin. Which of the following is the most likely diagnosis? a. Primary adrenal insuffi ciency (Addison disease) b. Prolactin-producing pituitary tumor c. Nonfunctioning pituitary tumor d. Pituitary apoplexy (Sheehan syndrome) e. Lymphocytic hypophysitis

Principles Of Pharmacology Med Assist
6th Edition
ISBN:9781337512442
Author:RICE
Publisher:RICE
Chapter11: Administration Of Nonparenteral Medications
Section: Chapter Questions
Problem 21RQ
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A 26-year-old woman presents at 4 weeks post partum with headaches, profound weakness, nausea, and vomiting. She had been breast-feeding. Physical examination fi ndings are unremarkable. Magnetic resonance imaging (MRI) of the head shows a sellar mass with suprasellar extension but without chiasmal compression. Laboratory test results (and reference ranges) include the following: serum sodium 125 mEq/L (136–142 mEq/L), serum prolactin 72 ? g/L (4–30 ? g/L), 8 am serum cortisol 3 ? g/dL (5–25 ? g/dL), serum adrenocorticotropic hormone (ACTH) 10 pg/mL (10–60 pg/mL), and normal values for serum free thyroxine and thyrotropin. Which of the following is the most likely diagnosis? a. Primary adrenal insuffi ciency (Addison disease) b. Prolactin-producing pituitary tumor c. Nonfunctioning pituitary tumor d. Pituitary apoplexy (Sheehan syndrome) e. Lymphocytic hypophysitis

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