Endocrine

Question 1

Etiology?

presentation?

tests?

treatment?

Answer 1

Etiology: Can be cosecreted with GH due to acromegaly; hypothyroidsm can lead to hyperprolactinemia because extremely high TRH will stimulate prolactin secretion

Physiological causes are pregnancy, intesne exercise, renal insuffiency, increased chest wall stimulation; cutting pituitary stalk

Drugs- antipsychotics, methyldopa, metoclopromide, opioids, TCA, verapamil

PRESENTATION: women present with galactorrhea, amenorrhea, infertility; men present with erectile dysfunction, decreased libido, gynecomastia.

DIAGNOSTIC TEST*:** *thyroid function test, pregnancy test, BUN/CRE (kidney disease elevates prolactin), LFT (cirrhosis elevates prolactin)

MRI is done after high prolactin is confirmed, secondary causes like medications is excluded AND patient is NOT pregnant.

TREATMENT: 1. Dopa agonists such as Cabergoline and bromocriptine. 2. Transphenoidal surgery for those not responding to meds