Pathology EMQ template

Your Name: Ameena Rahman

Your Identifier:

Theme: Pituitary

OPTION LIST

A	2.2mmol/l	I	Hydrocortisone
B	4.7mmol/l	J	Insulin tolerance test
C	Acromegaly	K	Low dose dexamethasone test
D	Adrenal failure	L	Non-functioning pituitary adenoma
E	Bitemporal hemianopia	M	Pregnancy
F	Cushing’s	N	Prolactinoma
G	Glucose tolerance test	O	Synacthen test
H	High dose dexamethasone test	P	Triple test

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 30 year old married woman complains of amenorrhoea, headaches and nausea. What is the most likely cause of her symptoms?

2. The insulin tolerance test requires adequate hypoglycaemia of less than this value.

3. The investigation carried out a patient who is thought to have a prolactinoma.

4. A 30 year old woman with a macroadenoma and a small visual defect. During CPFT investigations, she was found to have an increase in GH and a slight increase in prolactin, but no increase in cortisol, LH or FSH.

5. A 26 year old woman with a macroadenoma and bitemporal hemianopia. On CPFT investigation she has no increase in cortisol, TSH, LH or FSH but an increase in prolactin up to a maximum of 2944. What urgent treatment should she be given?

ANSWERS

1. P

2. A

3. Q

4. O

5. D