22.    A 33-year-old woman presents with a 2-week history of headache, vomiting and diplopia. Below is her X-ray.

a)        What two abnormalities does the X-ray (where the arrow is pointing) show?

           1.    Double flooring of the pituitary fossa.

            2.    Enlargement of the pituitary fossa.

b)         Name three other symptoms she may have.

            1.    Galactorrhoea.

             2.    Amenorrhoea.

             3.    Infertility.

c)         What other investigations would you order? Name three.  

            1.    Serum prolactin.

             2.    Visual fields mapping.

             3.    Thyroid function tests.

             4.    MRI / CT of the pituitary fossa.

d)         What is the probable diagnosis?

            Pituitary adenoma.

e)         Name one treatment.

             1.    Bromocriptine / carbergoline.

             2.    Hypophysectomy.

             3.    Radiotherapy.