A 24-year-old women has not had a period for about four months. She denies headaches or blurry vision or any other new symptoms on review of systems. You order a pregnancy test, and it comes back negative. You also order a prolactin level, and it comes back very high at 500 ng/mL. Which of the following is the most appropriate next step?
سؤال مجاني 2 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: A. MRI of the pituitary
A prolactin of >200 ng/mL (here 500) with pregnancy excluded is diagnostic of a prolactinoma; the next step is pituitary MRI to image the adenoma. It is not a lab error, and treatment (cabergoline/bromocriptine) is started after imaging.
ليش كل خيار صح أو غلط
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A
ليش صح
A prolactin permanently above 200 ng/mL (here 500) makes a prolactinoma most likely; the imaging step is a pituitary MRI to rule out an adenoma.
✓ Pituitary disorder.pdf · p. 7 -
B
ليش غلط
Dopamine agonists (bromocriptine, cabergoline) are the treatment and are listed after the diagnostic steps (prolactin level, then MRI to rule out an adenoma).
✓ Pituitary disorder.pdf · p. 7 -
C
ليش غلط
Not an error: hypothyroidism and drugs give only mild elevations (below 100 ng/mL), whereas a level above 200 points to prolactinoma.
✓ Pituitary disorder.pdf · p. 7 -
D
ليش غلط
Observation is for microprolactinoma with normal menses; this woman has amenorrhea and a prolactin of 500, so she needs the adenoma imaged.
✓ RT - Pituitary.pdf · p. 3
- المصدر
- Pituitary summary.pdf · p. 4
Pituitary disorder.pdf · p. 7 - المحاضرة
- Pituitary Disorders · Endocrinology · Module B
- ظهر في
- Endo bank