Neuroimaging: pituitary apoplexy: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Neuroimaging: pituitary apoplexy

Sample item

A man known to have a pituitary macroadenoma develops a sudden severe headache, visual loss and a third nerve palsy. Which imaging is most useful to confirm the cause?

AUrgent MRI of the sella showing haemorrhage or infarction within the adenomaBPlain skull radiographCCarotid DopplerDBone scan

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Urgent MRI of the sella showing haemorrhage or infarction within the adenoma

Sudden haemorrhage or infarction of a pituitary adenoma, called apoplexy, compresses the chiasm and cavernous sinus. MRI shows blood products within the mass, and CT may show a hyperdense sellar mass. Urgent steroids and neurosurgical review follow.

Option by option

A. Urgent MRI of the sella showing haemorrhage or infarction within the adenoma (correct)
Correct. MRI of the sella identifies haemorrhage in the adenoma.
B. Plain skull radiograph
A skull film cannot show the pituitary bleed.
C. Carotid Doppler
Carotid Doppler does not assess the sella.
D. Bone scan
A bone scan is irrelevant.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is A, Urgent MRI of the sella showing haemorrhage or infarction within the adenoma. Sudden haemorrhage or infarction of a pituitary adenoma, called apoplexy, compresses the chiasm and cavernous sinus.

Why is "Plain skull radiograph" not the answer?

A skull film cannot show the pituitary bleed.

Why is "Carotid Doppler" not the answer?

Carotid Doppler does not assess the sella.

Why is "Bone scan" not the answer?

A bone scan is irrelevant.

What concept does this question test?

It tests Neuroimaging: pituitary apoplexy in Radiology. MRI shows blood products within the mass, and CT may show a hyperdense sellar mass. Urgent steroids and neurosurgical review follow.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Neuroimaging: pituitary apoplexy?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.