2: Hyperprolactinaemia Flashcards
Define hyperprolactinaemia
Prolactin concentration >390
Define hyperprolactinaemia
Prolactin concentration >390
What is the most common endocrine disorder of the pituitary gland
Hyperprolactinaemia
What are the 3 mechanisms of hyperprolactinaemia
Prolactin-secreting tumour
Compression pituitary stalk (transmits dopamine from hypothalamus to pituitary gland)
Dopamine inhibition
What are 3 physiological causes of high prolactin
Pregnancy
Breast Feeding
Stress
What is the most common cause of high protection
Dopamine antagonists
What group of medications cause hpyerprolactinaemia and why
Dopamine antagonists. As dopamine, released by the hypothalamus, inhibits prolactin release.
Name anti-dopaminergic medications
Metclopramide
Antipsychotics
What two tumours can cause hyperprolacintaemia
Prolactinoma
Craniopharyngioma
In which gender are symptoms of high protecting usually first identified
Female - as symptoms are more obvious
What are symptoms of increase prolactin in females
Galactorrhoea
What are symptoms of decrease FSH and LH in females
- Amenorrhoea
- Infertility
What are symptoms of decreased testosterone in males
- ED
- Loss Libido
- Gynaecomastia
- Infertility
What are symptoms of decrease testosterone in females
- Loss libido
What are symptoms of decrease oestrogen in females
- Vaginal dryness
- Osteoporosis
What is first line investigation in suspected hyperprolactinaemia
Serum prolactin
What imaging is performed in hyperprolactinaemia
MRI Head
What does management of prolactinoma depend on
microprolactinoma or macroprolactinoma
What is a microprolactinoma
tumour less than 10mm on MRI
What is first-line in microprolactinoma
Bromocriptine
What is bromocriptine
Dopamine agonist
What is a macroprolactinoma
tumour more than 10mm on MRI
What is problem with macroprolactinoma
compress optic chiasm causing visual disturbance
What is indicated in macroprolactinoma
trans sphenoidal surgical resection
