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MedED Year 3 Endocrinology > Hyperprolactinaemia + Prolactinoma > Flashcards

Hyperprolactinaemia + Prolactinoma Flashcards

1
Q

Definition of hyperprolactinaemia?

A

Excess circulating prolactin

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2
Q

What other endocrine condition can you get hyperprolactinaemia in and why?

A

Hypothyroidism

  • Thyroid hormone not being released by thyroid gland so hypothalamus releases thyroid releasing hormone
  • this stimulates the thyroid, but also stimulates the anterior pituitary which will start to produce prolactin
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3
Q

Presentation of hyperprolactinaemia?

A

Galactorrhoea (w)
Amenorrhoea (w)
Infertility
Loss of libido

tumour

  • headache
  • visual field loss
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4
Q

Causes of hyperprolactinaemia?

A

Pituitary prolactinoma (commonest)
Hypothyroidism
Drugs (DA antagonists)
Physiological (pregnancy, breast feeding)

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5
Q

Investigations for hyperprolactinaemia?

A

Prolactin
TFTs
Pituitary/cranial MRI

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6
Q

Management of hyperprolactinaemia?

A

1st line - DA agonist (bromocriptine and cabergoline)

2nd line - surgery

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7
Q

Signs and symptoms of prolactinoma?

A

Presenting symptoms of hyperprolactinaemia + visual field defects and headaches

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8
Q

Investigations for suspected prolactinoma?

A

Serum prolactin
Pituitary MRI
Computerised visual field examination

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9
Q

Treatment of prolactinoma in pre-menopausal women?

A

Asymptomatic microprolactinomas - observation

Symptomatic microprolactinomas/macroprolactinomas - DA agonist

  • (oral contraceptive pill - 2nd-line if pregnancy not desired, otherwise ignore)
  • Surgery
  • Radiotherapy
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10
Q

Treatment of prolactinomas in post-menopausal women?

A

Microprolactinomas
- observation

Macroprolactinomas

  • DA agonist
  • Surgery
  • Radiotherapy
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11
Q

Treatment of prolactinomas in men?

A

Micro/macroprolactinomas

  • DA agonist
  • Surgery
  • Radiotherapy
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MedED Year 3 Endocrinology (11 decks)

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