18/10/2026
A 45-year-old woman is reviewed in the Endocrinology Clinic prior to surgery to remove a pituitary adenoma.
She presented to her General Practitioner a few weeks ago with hypertension, diabetes mellitus and changes
in her facial appearance, including prognathism and macroglossia.
On examination, her blood pressure in the clinic is 165/102 mmHg while her pulse is 84 bpm and regular. Her
body mass index is 23 kg/m .
Investigations:
1. Haemoglobin (Hb)
- Result: 120 g/l
- Normal value: 115–155 g/l
2. White cell count (WCC)
- Result: 7.2 × 10⁹/l
- Normal value: 4.0–11.0 × 10⁹/l
3. Platelets (PLT)
- Result: 199 × 10⁹/l
- Normal value: 150–400 × 10⁹/l
4. Sodium (Na⁺)
- Result: 142 mmol/l
- Normal value: 135–145 mmol/l
5. Potassium (K⁺)
- Result: 4.1 mmol/l
- Normal value: 3.5–5.0 mmol/l
6. Creatinine (Cr)
- Result: 110 µmol/l
- Normal value: 50–120 µmol/l
7. Glucose
- Result: 13.1 mmol/l
- Normal value: < 7 mmol/l
8. Insulin-like growth factor 1 (IGF-1)
- Result: 205 nmol/l
- Normal value: 11.3–29.1 nmol/l
What is the most appropriate treatment to provide this patient prior to surgery?
A. Cabergoline
B. Domperidone
C. Liraglutide
D. Octreotide
E. Phenoxybenzamine
