#8
QUESTION: A 47-year-old woman with a history of hypertension presents to the ED with a severe headache that began suddenly 3 hours prior to arrival. She has a history of recurrent frontal headaches for the last month and is currently being treated for a migraine headache. Today, she also complains of blurry vision, diplopia, nausea, vomiting, and confusion. Her vital signs are BP 95/45 mm Hg, HR 118, RR 23, T 98.2°F, and pulse oximetry of 98% on room air. On exam, she appears somnolent. Neurologic exam reveals a dilated, minimally reactive left pupil, a globe that is deviated inferiorly, and bitemporal hemianopsia. Lab results only reveal hyponatremia of 129. Normal saline is administered and a CT scan reveals an intraseller mass. Which of the following is an appropriate step in the management of this patient?
A. Administer intravenous 3% saline
B. Administer intravenous hydrocortisone
C. Administer intravenous mannitol
D. Arrange for rapid radiation therapy
4 Comments
Thank you for putting together the questions for the mini board review. I find them very helpful!
Good review….but alot of medical info, very specific…not known when you are out for years in practice.
Thanks for your effort. Nice to review uncommon diseases to keep us up to speed. It is amazing how many diseases, pathogens etc… have had their names changed : Granulomatosis with Polyangiitis (GPA) (formerly referred to as Wegener’s granulomatosis).
Excellent review questions. Please keep them coming in future issues!