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Pituitary apoplexy — SCE Endocrinology MCQ

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EasyPituitaryPituitary apoplexySCE Endocrinology

A 28-year-old woman develops sudden severe headache, vomiting and diplopia. She has known pituitary macroadenoma. Blood pressure is 88/50 mmHg and sodium is 128 mmol/L. What is the most appropriate immediate management?

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Correct answer: D — Urgent hydrocortisone and pituitary apoplexy pathway review

Pituitary apoplexy can cause acute ACTH deficiency and visual compromise, requiring urgent hydrocortisone and specialist neurosurgical/endocrine assessment. Delaying steroids for investigations is unsafe in shock. Visual deficits determine the urgency of decompression.

Reference: Society for Endocrinology Pituitary Apoplexy Guidance