試題詳解

120. 58歲女性病人，因為血壓低及意識不清被送至急診。她的內分泌檢查顯示 fT4 0.65 ng/dL, hsTSH 0.32uIU/mL, cortisol (8 am) 5 ug/dL, ACTH 40 pg/mL, GH 2.5 ng/mL, prolactin 6 ng/mL。下列哪一個選項，最支持腦垂體功能不全(hypopituitarism) 診斷？(參考值: fT4 0.70~1.48 ng/dL； hsTSH 0.35~4.94uIU/mL；cortisol (8am) 5~25 ug/dL； cortisol (4pm) 2.5~12.5 ug/dL； ACTH 7.4~57.3pg/mL； GH ＜8 ng/dL；prolactin 5~23 ng/mL)
(1) insulin hyoglycemia test, 當 glucose ＜40 mg/dL時, GH 為 6 ng/mL.
(2) Insulin hypoglycemia test, 當 glucose ＜ 40 mg/dL時, cortisol 為 9 ug/dL.
(3) TRH stimulation test, peak TSH 4.25 uIU/mL.
(4) TRH stimulation test, peak prolactin 19 ng/mL.
(5) CRH stimulation test, peak ACTH 90 pg/mL.
(A) (1)+(2)
(B) (2)+(3)
(C) (3)+(4)
(D) (1)+(2)+(3)
(E) (2)+(3)+(5)