A 30-year-old woman has oligomenorrhea for 8 months, she has a history of severe gastritis for which she takes proton pump inhibitor. On examination, she has bilateral galactorrhea. Which of the following should be the next step?
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الإجابة: C. Serum prolactin
Galactorrhoea with oligomenorrhoea is investigated first by measuring serum prolactin to confirm hyperprolactinaemia; drugs and hypothyroidism are then excluded as causes. Stopping the PPI or starting cabergoline before confirming high prolactin is premature (the sources list H2 blockers, not PPIs, among causative drugs).
ليش كل خيار صح أو غلط
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A
ليش غلط
The list of drugs raising prolactin includes H2 blockers (not PPIs), and hyperprolactinemia is not yet confirmed, so stopping the PPI is premature.
✓ RT - Pituitary.pdf · p. 2 -
B
ليش غلط
Cabergoline is the treatment of hyperprolactinemia; first the diagnosis (serum prolactin above 200 ng/mL, MRI, TSH) must be made.
✓ Pituitary summary.pdf · p. 4 -
C
ليش صح
Galactorrhea is the indication to obtain a serum prolactin; a level above 200 supports hyperprolactinemia.
✓ 4• Pituitary Disorders [Notes].pdf · p. 7 -
D
ليش غلط
TSH is checked to rule out hypothyroidism as a cause of hyperprolactinemia; the diagnostic test for the galactorrhea itself is the serum prolactin.
✓ Pituitary summary.pdf · p. 4
- المصدر
- 4• Pituitary Disorders [Notes].pdf · p. 7
RT - Pituitary.pdf · p. 2 - المحاضرة
- Pituitary Disorders · Endocrinology · Module B
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