endocrine question - diva

[ArchivalUser]

hi guys,
this is an endocrine q.


a 29 y.o woman came to office with 3 mths history of amenorrea and galactorrea.she dont think she is pregnanat because she is not sexually active.she is increased in weight recently.on examination she has pr 64, rr 20, she has normal cns examination and the neck is full- there may be slight thyroid enlargement.

what is the next step to do?
order

1. prolactin
2.dexa methasone suppression test
3.ORAL GTT
4.TSH.
5.MRI BRAIN

[ArchivalUser]

4) Hypothyrodism... first thing to rule out

[ArchivalUser]

1. prolactin

[ArchivalUser]

TSH

Hypothyroidism can give you increase in prolactine level so r/o first. if THS is normal them Prolactine level

[ArchivalUser]

Primary Hypothyroidism, the increased in TRH stimulates the release of prolactine, is the first to rule out.

[ArchivalUser]

hi guys,
TSH is the correct answer as everybody knows. primary hypothyroidism simulates hyperprolactinemia.its because TRH has structural similarity to prolactin.when the feedback is more severe they may even get visual symptoms just like pituitary adenoma. hypothyroidism is much more common than pituitary adenomas and they will get amenorrea and also galactorrea sometimes. bye. diva