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Flashcards in Galactorrhea Deck (17):
0

Symptoms of a pituitary secreting adenoma?

1. Galactorrhea
2. Headache
3. Bitemporal hemianopsia

1

To determine if breast discharge is truly galactorrhea?

Microscopic smear shows fat droplets

2

Why does hypothyroidism cause hyperprolactinemia?

Increased TRH triggers increase in prolactin secretion

3

Effect of prolactin on other hormones? Results in?

Inhibits GnRH pulsations from hypothalamus

Amenorrhea

6

Mildly elevated hyperprolactinemia in the range of? Follow up test?

If markedly high prolactin level – test?

20-60; TRH test

MRI

7

Causes of hyperprolactinemia?

1. Hypothalamic
2. Pituitary adenoma or empty sella syndrome
3. Acromegaly
4. Hypothyroidism
5. Chest surgery/trauma (breast implants, herpes zoster)
6. Renal disease
7. Drugs

8

Hypothalamic causes of hyperprolactinemia?

Craniopharyngioma, sarcoidosis, histiocytosis, leukemia

9

Drug causes of hyperprolactinemia?

1. Tranquilizers
2. TCA
3. Antihypertensives
4. Narcotics
5. OCP

10

Patients with secondary amenorrhea have a significantly greater chance of having a pituitary adenoma if?

Low serum estrogen (<40)

11

When to expectantly manage an adenoma?

1. Microadenoma
2. No estrogen deficiency
3. Patient does not wish to conceive

12

Hormone deficiency that can lead to hyperprolactinemia?

Primary hypothyroidism

Thyroxine

13

Patient with hyperprolactinemia and low estrogen that wish to conceive – drug? Why not give to all? Drug if that fails?

Bromocriptine (DA agonist); side effects (orthostatic hypotension, nausea vomiting)

Cabergolamine

14

Treatment for patient with hyperprolactinemia with adequate estrogen (greater than 40) who do not desire pregnancy?

Periodic progestin withdrawal

15

Description of surgery for pituitary adenoma?

Cure rate associated with?

Transsphenoidal microsurgery

Pretreatment prolactin levels (level of 100 has a good prognosis; level of 200 has poor prognosis)

16

Patient with suspected prolactinoma while pregnant – treatment?

Bromocriptine

17

Complications of adenoma surgery?

1. Transient DI
2. Hemorrhage, CSF leak, meningitis

18

Potential pretreatment before pituitary adenoma surgery?

Bromocriptine to reduce size of adenoma