Endocrinology

Question 1

What symptoms do females get with a prolactinoma?

Answer 1

Amernnorheoa, galactorrheoa, decreased libido, increased weight

Usually microadenomas so no visual defects

Question 2

What symptoms do males get with a prolactinoma?

Answer 2

Decreased libido / erectile dysfunction

Macroadenomas so bitemporal hemianopia, headache, palsy of CN III, IV, VI

Question 3

What Ix do you do for prolactinomas?

Answer 3

Check medications
TSH
Prolactin Levels
MRI

Question 4

What is the management of prolactinoma?

Answer 4

Dopamine agonists: cabergoline or Bromocriptine

Can do radiotherapy / surgery if DA doesn’t work

Question 5

What are some causes of hyperprolactinaemia?

Answer 5

Physiological = pregnancy, breastfeeding, stress

Pituitary = Micro or Macroadenoma

Drug-induced = Antipsychotics, methyldopa, SSRI

Systemic = hypothyroidism, CKD, PCOS, epilepsy
Idiopathic

Question 6

If hyperprolactinaemia is suspected, which investigations could you do?

Answer 6

b-hcg, Serum prolactin level, TFT, UEC, MRI