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Pituitary apoplexy — RCPSC IM MCQ

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HardEndocrinologyPituitary apoplexyRCPSC IM

A 50-year-old man has sudden severe headache, vomiting, diplopia and reduced visual fields. He is hypotensive and hyponatremic. CT head shows sellar hemorrhage in a known macroadenoma. Morning cortisol is pending. What is the most appropriate management?

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Correct answer: C — Immediate stress-dose hydrocortisone and urgent neurosurgical-endocrinology assessment

Pituitary apoplexy with hemodynamic instability or visual compromise requires urgent glucocorticoids and neurosurgical/endocrine assessment. Steroids should not wait for cortisol results.

Reference: Canadian endocrinology pituitary disease guidance