A 46 year old male with decreased lopido and erectile dyfunction Testesteron LOW lab result at am Testesteron (low) Cortisol ( normal ) Prolactin ( very high ) TSH ( normal ) MRI show pitutary adenoma 1.7 cm No visual field proplem What is the next step ?
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الإجابة: D. capirgolin
Very high prolactin with a 1.7 cm pituitary adenoma means a prolactinoma (macroprolactinoma) causing hypogonadism: low testosterone, low libido and ED. A symptomatic prolactinoma is treated first with a dopamine agonist, cabergoline, which is preferred to bromocriptine. Surgery is for prolactinomas that do not respond to dopamine agonists, and radiotherapy is an adjunct. Testosterone replacement (A) does not treat the cause; lowering prolactin usually restores the gonadal axis.
ليش كل خيار صح أو غلط
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A
ليش غلط
The low testosterone is a result of the prolactin: high prolactin inhibits GnRH and so lowers LH and FSH; the cause is treated rather than just replacing testosterone.
✓ Step Up To Medicine 6th Edition 2024 (Pituitary).pdf · p. 2 -
B
ليش غلط
Surgery is for mass effect, visual field defects, hypopituitarism, or prolactinomas unresponsive to dopamine agonists; he has no visual problem and has not yet had medical treatment.
✓ RT - Pituitary.pdf · p. 3 -
C
ليش غلط
For a prolactinoma, medical management is tried first; radiation therapy is listed only as an adjunct.
✓ Step Up To Medicine 6th Edition 2024 (Pituitary).pdf · p. 2 -
D
ليش صح
Symptomatic prolactinoma is treated with a dopamine agonist, cabergoline (preferred to bromocriptine).
✓ RT - Pituitary.pdf · p. 3
- المصدر
- RT - Pituitary.pdf · p. 3
Step Up To Medicine 6th Edition 2024 (Pituitary).pdf · p. 2 - المحاضرة
- Pituitary Disorders · Endocrinology · Module B
- ظهر في
- MED43 ♀ Quiz B