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Hypopituitarism — SCE Endocrinology MCQ

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EasyPituitaryHypopituitarismSCE Endocrinology

A 57-year-old woman has pituitary macroadenoma and severe hypothyroxinaemia. She is cortisol deficient and has not yet started replacement. What is the most appropriate first hormone replacement?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Hydrocortisone before levothyroxine

Glucocorticoid replacement should precede levothyroxine in combined pituitary failure because thyroid hormone increases cortisol clearance and can precipitate adrenal crisis. Cabergoline is not the priority unless a prolactinoma is confirmed. This sequencing is frequently tested in pituitary medicine.

Reference: Society for Endocrinology Pituitary Guidance; BNF