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Retired NBME 15 Answers

nbme15/Block 1/Question#5 (reveal difficulty score)
An 18-year-old man comes to the physician ...
Prolactin ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—cassdawg(1781)
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The most common hormone secreting tumor of the pituitary is a prolactinoma (FA2020 p526)

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taylor5479  To add to this, I interpreted the question to imply that a "cystic" tumor may not be secreting any hormones at all since it is essentially empty space. Since prolactin is normally inhibited by dopamine signaling from the hypothalamus, any lesion that physically interrupts this pathway would also cause a rise in prolactin. +1



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submitted by โˆ—torticollis(4)
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Probably a craniopharyngioma since it is a cystic tumor. Above the silla turcica and not in it makes me think more of craniopharyngioma.

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athenathefirst  Yeah I was between craniopharyngioma and prolactinoma but the fact we didn't see machine oil made me eliminate craniopharyngioma. I am suspecting pituitary adenoma and in the case of prolactinoma, wouldn't we see galactorrhea. So I am suspecting this is pituitary adenoma since it's an adult tumor which shows with mass effect. Pituitary adenoma involves the hypertrophy of only one type of endocrine cells, most commonly lactotrophs (prolactin). FA 2019 page 514. +



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