Pathology EMQ template.

Name: Shumonta Quaderi

Candidate number:

Theme: Pituitary

OPTION LIST

A	Combined pituitary function test (CPFT)	I	ECG & exclude Hx of IHD or epilepsy
B	Head CT	J	Complete hypopituitarism
C	β-HCG levels	K	Cabergoline
D	Serum prolactin levels	L	Bromocriptine
E	Microadenoma	M	Non-functioning pituitary adenoma
F	0.35 units/kg	N	IGF-1
G	Octreotide	O	Glucose tolerance test
H	0.15 units/kg	P	Aldosterone

For each scenario below, choose the most appropriate answer from the list above. Each option may be used once, more than once or not at all.

1. A 25 year old woman complains of amenorrhoea, weight gain and some slight visual disturbances. She is sexually active. What initial test would you like to do?

2. A 30 year old lady comes in with amenorrhoea and galactorrhoea. Her prolactin levels come back as 25,000 CT shows a macroadenoma. What investigation should be performed next?

3. The CPFT/Triple test is done by administering LHRH, TRH and one other hormone. What dose of this other hormone should be administered?

4. A 28 year old woman comes in with a visual field defect. A CT scan revealed a large (2cm) pituitary adenoma. A CPFT was performed showing increased Growth hormone at set intervals. What dynamic test should be performed next?

5. A patient has been diagnosed with complete hypopituitarism. She is urgently given hydrocortisone. As well as replacement of other essential hormones what other medication will she need?

ANSWERS

1. C

2. A

3. H

4. O

5. K