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Actually I have two questions:
1. In USMLE Step 2 Secret, page 93, Item #41, it claims that OCP can cause nipple discharge. Can anyone explain?
2. Another question: what is the most common bug cause osteomyelitis in sickle cell pt? S. aureus or salmonella? Dr. Fischer mentioned in DVD is S. aureus but many books said is salmonella. Any comment?
Thank you forum!
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Women who take oral contraceptives or who take hormone therapy after menopause may have nipple discharge. When levels of the female hormones estrogen and progesterone increase (during the menstrual cycle or pregnancy or because of OCP/HRT), they cause the milk glands and ducts of the breasts to enlarge and the breasts to retain fluid. this may cause nipple discharge...sometimes breast pain/tenderness.
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staph aureus most common in general population including sickle cell patients.
But when it comes to salmonella, its more prevalent in sickle cell patients compared to gen population,
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Thanks for response.
I understand estrogen causes milk glands/ducts development. But my problem for 1st question is that Estrogen acutally suppresses prolactin in pregnancy (which is why pregnant ladies don't lactate until placenta is out). So how can we now say estrogen leads to nipple discharge? Maybe 'nipple discharge' here is different from lactation?
ddimer001, I know that is what Dr. Fischer explained. But I checked couple books and they all clearly say the most common pathogen for osteomyelitis in Sickle cell pt is Salmonella. So I am concerned.
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oc pills they are nothing but kind of steroids so they inhibit the HPO axis. so the point here is prolactin inhibiting factor is inhibited that makes more prolactin so resulting as nipple discharge..
Your 2nd question most common cause of osteomyelitis in sickle cell disease is SALMONELLA
You might have 2000 kaplan conrod fischer vedios I guess.. At that time they thought staph was common cause os osteomyelitis in sickle cell disease as told by Dr. Feishcher...
But now its Salmonella the common cause of osteomyelitis in sickle cell disease
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I agree with ritonavir.. just i would like to add that there are many secretory stimulus for prolactin and one of them is estrogen and as we all know that ocps are estrogen and progestron.. so just giving a high dose of estrogen is enough to cause prolactin secretion and promotes milk production.. milk production can occur for the same reason(increase in PRL) in pregnancy and mid menestrual cycle due to an increase in estrogen level.
