Page 1 of 1: MCQE2 Question: Lateral visual field defect/HIV/Cranial nerve exam

Kai1111 · Credits: 2036 My Scrapbook

3. HIV/ Cranial nerve examination
A 24-year-old man, a diagnosed case of HIV has developed some visual problems.
Examine his cranial nerves.
On Physical examination his field of vision on the lateral sides was impaired
Post encounter probe

Differential DIAGNOSIS
Lymphomas
Toxoplasmosis
Tubersulosis

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Treatment
Pyremethamine

This question came from a 'MCQE2 question bank.' It seems like his sxs are c/w a bitemporal hemanopsia......with this sx, I always think of a pituitary tumor.....&....the most common form is an adenoma. Curious to know others impressions and thoughts...is the HIV status distracting the examiner from the most common cause of this condition or ????

My Ddx: Pit adenoma, lymphoma, toxo (if h/o +ppd, then TB?)
My Tx: Head /MRI/CT, endocrine w/u....then oncology/neurosurg consult?

Here are a few case reports (very rare) of toxoplasmosis assoc w pituitary tumors:

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With regard to lymphomas and pituitary tumors....again really rare, but it does happern:

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TB and pituitary tumors: really rare

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National Cancer Institute tx options for pituitary adenomas:

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Have gone down the wrong path? Help.

vanjik · Credits: 371 My Scrapbook

there was a CT scan finding at PEP

QUESTION ) What is your reading ?

QUESTION ) What is your treatment ?

but I am not for sure what is the right answer....

Kai1111 · Credits: 2036 My Scrapbook

Didn't know there was a CT scan at the station.....changes everything....I guess...which leads to the question that if there is a lateral field deficit and it is not from a pituitary mass, what can cause the sxs?

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