Endocrinology Question 15 Instructor

Anita Blythe is a 24 year-old woman with a 4-month history of amenorrhea and galactorrhea.

List 5 reasons why her prolactin may be elevated.

  • Physiologic:
    • pregnancy
    • breast feeding
    • nipple stimulation
  • Drug induced:
    • Dopamine antagonist
    • domperidone
  • Endocrine:
    • Primary hypothyroidism
    • Addison’s disease
  • Decreased clearance:
    • renal failure
    • hepatic failure
  • Central:
    • prolactinoma
    • stalk-effect from pituitary macroadenoma
  • Macroprolactin (unlikely, since symptomatic)

What is the primary therapy for a symptomatic prolactinoma?

Dopamine agonists: cabergoline, bromocriptine, or quinagolide.

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