A 45-year-old male patient is diagnosed with hypopituitarism. Which of the following interventions is the most appropriate initial action for managing this condition?
Administering intravenous fluids.
Performing a transsphenoidal hypophysectomy.
Initiating hormone replacement therapy.
Recommending dietary modifications.
The Correct Answer is C
Choice A Reason:
Administering intravenous fluids is not the most appropriate initial action for managing hypopituitarism. While IV fluids may be necessary in cases of acute adrenal crisis or severe dehydration, they do not address the underlying hormone deficiencies caused by hypopituitarism. The primary treatment focuses on replacing the deficient hormones to restore normal physiological functions.
Choice B Reason:
Performing a transsphenoidal hypophysectomy is a surgical procedure used to remove pituitary tumors. While this may be necessary if a tumor is causing hypopituitarism, it is not the initial action for managing the condition. The first step is to stabilize the patient with hormone replacement therapy before considering surgical interventions.
Choice C Reason:
Initiating hormone replacement therapy is the most appropriate initial action for managing hypopituitarism. This condition results in the deficiency of one or more pituitary hormones, and replacing these hormones is crucial to restore normal body functions. Hormone replacement therapy may include cortisol, thyroid hormone, sex hormones, and growth hormone, depending on which hormones are deficient.
Choice D Reason:
Recommending dietary modifications alone is not sufficient to manage hypopituitarism. While a balanced diet can support overall health, it does not address the specific hormone deficiencies associated with this condition. Hormone replacement therapy is essential for managing hypopituitarism effectively.
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Related Questions
Correct Answer is D
Explanation
Choice A Reason:
Primary hyperparathyroidism is characterized by elevated PTH levels, which lead to increased serum calcium levels and decreased serum phosphate levels. The patient’s lab results show low PTH and low serum calcium, which are not consistent with primary hyperparathyroidism.
Choice B Reason:
Chronic kidney disease (CKD) can cause disturbances in calcium and phosphate metabolism, but it typically presents with elevated PTH levels due to secondary hyperparathyroidism. The patient’s low PTH levels make CKD an unlikely diagnosis in this context.
Choice C Reason:
Vitamin D deficiency can lead to low serum calcium levels, but it usually results in elevated PTH levels as the body attempts to compensate for the low calcium. The patient’s low PTH levels do not align with a diagnosis of vitamin D deficiency.
Choice D Reason:
Hypoparathyroidism is characterized by low serum calcium, low PTH levels, and elevated serum phosphate levels. This condition occurs when the parathyroid glands do not produce enough PTH, leading to the observed lab results and symptoms such as tingling, muscle cramps, and fatigue. The patient’s lab results are consistent with hypoparathyroidism.
Correct Answer is B
Explanation
Choice A Reason:
Adrenal hyperplasia involves the enlargement of the adrenal glands, which can lead to an overproduction of adrenal hormones. However, it does not directly cause hyperpituitarism. Hyperpituitarism is related to the overactivity of the pituitary gland, not the adrenal glands.
Choice B Reason:
Pituitary adenoma is the most common cause of hyperpituitarism. These benign tumors in the pituitary gland lead to the overproduction of one or more pituitary hormones, causing symptoms such as severe headaches, visual disturbances, and joint pain. The pituitary gland’s overactivity due to the adenoma results in the excessive release of hormones, which can affect various bodily functions.
Choice C Reason:
Thyroid carcinoma is a type of cancer that affects the thyroid gland While it can cause hormonal imbalances, it does not typically lead to hyperpituitarism. The symptoms described are more consistent with a pituitary-related issue rather than a thyroid condition.
Choice D Reason:
Hypothalamic dysfunction can affect the pituitary gland’s function since the hypothalamus regulates pituitary hormone release. However, it is less likely to be the primary cause of hyperpituitarism compared to a pituitary adenoma. The direct overproduction of hormones by the pituitary gland is more commonly due to an adenoma.
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