A young lady with symptoms of hypehyroidism with elevated T4 and TSH levels were 8.5. Fuher examination reveals bitemporal hemianopia. Next step of management:
Correct Answer: Sta antithyroid drugs, and do urgent MRI brain
Description: Ans: A. Sta antithyroid drugs, and do urgent MRI brain(Ref Harrison 19/e p2274. 18/e p2880; Sabiston 20/e p982, 19/e p1890; Schwaz 10/e p1533, 9/e p1541: Bailey 27/e p8 1 1, 26/e p614-616)Hypehyroidism with elevated T4 and TSH levels and bitemporal hemianopia is highly suggestive of TSH-secreting adenoma.MRI - Confirm TSH-secreting pituitary adenoma diagnosis.TSH producing macroadenomas:Rare.Often large & locally invasive.Along with thyroid goiter & hypehyroidism, reflecting TSH overproduction.Diagnosis:Elevated serum free T4 levels.Inappropriately normal or high TSH secretion.MRI - Evidence of pituitary adenoma.
Category:
Surgery
Get More
Subject Mock Tests
Practice with over 200,000 questions from various medical subjects and improve your knowledge.
Attempt a mock test nowMock Exam
Take an exam with 100 random questions selected from all subjects to test your knowledge.
Coming SoonGet More
Subject Mock Tests
Try practicing mock tests with over 200,000 questions from various medical subjects.
Attempt a mock test now