Prolactinoma

Question 1

in prolactinomas, is there excess or deficient amount of prolactin?

Answer 1

excess

Question 2

what is the most common secretory adenoma?

Answer 2

prolactinoma

Question 3

prolactinomas are tumors on what cells of anterior pituitary

Answer 3

lactroph cells

Question 4

______ is responsible for lactation

Answer 4

prolactin

Question 5

overproduction of prolactin causes suppression of normal gonadotropin releasing hormone causing impaired LH and FSH, this results in what in men?

Answer 5

hypogonadism

Question 6

symptoms in females

Answer 6

o Infertility
o Menstrual disturbances
o Oligo (scant bleeding), amenorrhea, irregular, delayed menarche
o Galactorrhea: spontaneous or expressive
o Hypoestrogenism: vaginal dryness/dyspareunia, osteoporosis/-penia

Question 7

symptoms in males

Answer 7

o	Hypogonadism
o	Decreased libido
o	Erectile Dysfunction 
o	Infertility 
o	Gynecomastia
o	If prepubescent: female body habitus/small testicles

Question 8

what inhibits prolactin release?

Answer 8

dopamine

Question 9

work-up for prolactinoma

Answer 9

PRL measurement–> serum prolactin level will be greater than 200 mcg/l in micro adenoma
before drawing prolactin levels make sure a breast exam wasn’t just done
MRI of brain

Question 10

treatment of prolactinomas

Answer 10

dopamin agonists- bromocriptine, cabergoline
preferred surgical treatment: transsphenoidal pituitary adenomectomy
radiation therapy- only effective 25% of time

Question 11

treatment goal of prolactinomas

Answer 11

control or shrink pituitary lesion and restore normal function

Question 12

as management for your pt with prolactinoma, what will you need to monitor?

Answer 12

PRL levels and serial MRIs