Pituitary adenoma physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ahmad Al Maradni, M.D. [2]

Overview

The presence of altered mental status, nausea, lethargy and visual field defect (bitemporal hemianopsia) on physical examination is suggestive of pituitary adenoma.

Physical Examination

Appearance of the Patient

• Based on the size of the adenoma and type of the hormone that being secreted patient may appears lethargic, nauseated, drowsy, obese, thin, or diaphoretic. However, patient may also appears well.

Vitals

Temperature

• Hyperthermiamay be present

Pulse

Rate

• Tachycardia may be present

Rhythm

• The pulse is regular

Strength

• The pulse may be bounding

Blood Pressure

• Hypertension may be present

Respiratory Rate

• Tachypnea may be present

Neurologic

• Mental status may be altered
• Hyperactive reflexes may be present
• Deficits in cranial nerves I, II, III, and VI may be present

Eyes

• Visual filed defect (bitemporal hemianopsia) maybe be present

Chest

• Breasts may be enlarged