HPT Axis And Disorder Clinical Case Flashcards
Clinical Case Question
Answer
A 45-year-old woman presents with irregular menstruation, galactorrhea, and infertility. Serum prolactin is elevated. What is the most likely diagnosis?
Prolactinoma.
A 55-year-old man with uncontrolled hypertension has episodes of palpitations, headache, and sweating. His plasma metanephrines are elevated. What is the diagnosis?
Pheochromocytoma.
A 30-year-old woman presents with amenorrhea, fatigue, and cold intolerance. TSH and free T4 are both low. What is the most likely diagnosis?
Secondary hypothyroidism due to pituitary dysfunction.
A 50-year-old woman with a history of prolonged corticosteroid use presents with fatigue, weight loss, and hypotension. What is the likely diagnosis?
Secondary adrenal insufficiency due to chronic steroid use.
A 25-year-old man has a large pituitary adenoma and complains of tunnel vision. What is the likely visual defect?
Bitemporal hemianopia due to optic chiasm compression.
A 7-year-old boy presents with short stature and delayed bone age. GH levels are low, and IGF-1 is decreased. What is the most likely diagnosis?
Growth hormone deficiency.
A 65-year-old man with a pituitary tumor presents with coarse facial features, enlarged hands, and glucose intolerance. What is the diagnosis?
Acromegaly due to excess GH secretion.
A 40-year-old woman presents with excessive thirst and urination. Serum sodium is high, and urine osmolality is low. What is the most likely diagnosis?
Diabetes insipidus.
A patient with a history of traumatic brain injury develops polyuria and polydipsia. Water deprivation test shows no increase in urine osmolality. What is the diagnosis?
Central diabetes insipidus.
A 28-year-old woman presents with fatigue, nausea, and hyperpigmentation. Serum cortisol is low, and ACTH is high. What is the diagnosis?
Primary adrenal insufficiency (Addison’s disease).
A 45-year-old man presents with hypertension, hypokalemia, and metabolic alkalosis. Plasma aldosterone is high, and renin is low. What is the likely diagnosis?
Primary hyperaldosteronism (Conn’s syndrome).
A 50-year-old man presents with persistent headaches and decreased libido. Serum testosterone and LH are low. What is the most likely diagnosis?
Hypogonadotropic hypogonadism due to pituitary dysfunction.
A 60-year-old man presents with lethargy, weight gain, and cold intolerance. TSH is low, and free T4 is low. What is the diagnosis?
Secondary hypothyroidism.
A 30-year-old man presents with episodic hypertension and a family history of multiple endocrine neoplasia type 2A. What condition should be suspected?
Pheochromocytoma.
A 22-year-old woman presents with irregular periods, acne, and hirsutism. Serum testosterone and DHEA-S are elevated. What is the likely diagnosis?
Androgen-secreting adrenal tumor.
A 10-year-old girl presents with early breast development and pubic hair growth. What condition should be suspected?
Precocious puberty due to hypothalamic-pituitary axis activation.
A 40-year-old man presents with obesity, moon facies, and proximal muscle weakness. His 24-hour urine cortisol is elevated. What is the most likely diagnosis?
Cushing’s syndrome.
A patient with suspected Cushing’s syndrome has undetectable ACTH. What is the likely cause?
Adrenal adenoma (ACTH-independent Cushing’s syndrome).
A 50-year-old woman presents with severe postpartum hemorrhage and later develops fatigue, amenorrhea, and low cortisol levels. What is the likely diagnosis?
Sheehan’s syndrome (postpartum pituitary infarction).
A 70-year-old man presents with severe hyponatremia, confusion, and euvolemia. His urine osmolality is inappropriately high. What is the diagnosis?
SIADH (Syndrome of Inappropriate ADH Secretion).
A 16-year-old boy presents with delayed puberty, anosmia, and low testosterone levels. What is the most likely diagnosis?
Kallmann syndrome (congenital GnRH deficiency).
A 45-year-old woman presents with galactorrhea, infertility, and headache. MRI shows a pituitary mass. What is the likely diagnosis?
Prolactinoma.
A 5-year-old girl presents with rapid growth, early pubic hair, and advanced bone age. What is the most likely diagnosis?
Congenital adrenal hyperplasia (CAH).
A patient with a non-functioning pituitary adenoma develops secondary adrenal insufficiency. What hormone is deficient?
ACTH.
A 28-year-old woman with a history of hypothalamic dysfunction presents with polyuria, polydipsia, and dilute urine. What test is used to confirm the diagnosis?
Water deprivation test.
A 60-year-old man with a history of small cell lung cancer develops severe hyponatremia. Urine osmolality is high despite low plasma osmolality. What is the diagnosis?
SIADH.
A 35-year-old woman presents with recurrent kidney stones, constipation, and depression. Serum calcium is high, and PTH is elevated. What is the likely diagnosis?
Primary hyperparathyroidism.
A 30-year-old woman presents with easy bruising, weight gain, and hypertension. Low-dose dexamethasone suppression test fails to suppress cortisol. What is the likely diagnosis?
Cushing’s syndrome.
A patient with pituitary surgery develops low cortisol levels but normal aldosterone. What is the likely cause?
Secondary adrenal insufficiency due to ACTH deficiency.
A 50-year-old man presents with headaches, visual field defects, and low levels of pituitary hormones. MRI shows a large sellar mass. What is the diagnosis?
Non-functioning pituitary adenoma.
A 45-year-old woman with recurrent DVTs has elevated ACTH and cortisol levels. What is the suspected condition?
Cushing’s disease (ACTH-secreting pituitary adenoma).
A 12-year-old boy presents with short stature and delayed puberty. GH levels are low. What is the likely diagnosis?
Growth hormone deficiency.
A 70-year-old man presents with fatigue, hypotension, and hyperpigmentation. ACTH is high, and cortisol is low. What is the diagnosis?
Primary adrenal insufficiency (Addison’s disease).
A 30-year-old woman presents with infertility and high FSH and LH levels. What is the likely diagnosis?
Primary ovarian failure.
A 35-year-old man presents with headache, sweating, and hypertension. Plasma metanephrines are elevated. What is the most likely diagnosis?
Pheochromocytoma.
A 40-year-old woman presents with an enlarging pituitary mass and bitemporal hemianopia. What is the best initial imaging modality?
MRI of the pituitary.
