Hyperprolactinemia & Galactorrhea Flashcards Preview

OBGYN > Hyperprolactinemia & Galactorrhea > Flashcards

Flashcards in Hyperprolactinemia & Galactorrhea Deck (28):
1

define hyperprolactinemia

elevated levels of prolactin

2

define glactorrhea (be specific)

watery or milky d/c from the breasts that is NOT in relation to pregnancy

3

what is a prolactinoma?

prolactin secreting tumor of the pituitary gland

4

what are some physiologic stimuli for prolactin release? @ least 3

breast and nipple palpation, exercise, stress, sleep, noonday meal (?!)

5

what is the most common cause of mildly elevated prolactin levels? think ...

STRESS!

6

what is the most common cause of galactorrhea and hyperprolactinemia?

medication use

7

what is the most common pituitary adenoma associated with hyperprolactinemia?

prolactinoma

8

what two tests should be done to initiate the evaluation of hyperprolactinemia?

serum prolactic and thyrotopin-stimulating hormone (TSH)

9

what is the main function of prolactin?

to stimulate growth of mammary tissue as well as produce and secrete milk into the alveoli (this is how increased prolactin - aka hyperprolactinemia) leads to galactorrhea.

10

prolactin release is stimulated by what time substances?

TRH (thyrotropin releasing hormone) and serotonin

11

prolactin release is inhibited by what substance?

dopamine

12

what is the relationship between hyperprolactinemia and GnRH?

hyperprolactinemia inhibits GnRH which leads to amenorrhea/oligomenorrhea, anovulation, and inappropriate lactation/galactorrhea

13

t or f: hyperthyroidism is a cause of hyperprolactinemia

FALSE - hyPO is a cause (b/c remember, in this instance you will have increased levels of TRH)

14

t or f: empty sella syndrome is a cause of hyperprolactinemia

TRUE - intrasellar extension of SA space causes compression of the pit gland and an enlarged sella turcica

15

t or f: acromegaly is a cause of hyperprolactinemia

TRUE

16

t or f: chronic renal dz is a cause of hyperprolactinemia

TRUE - decreases metabolic clearance of prolactin

17

t or f: breast implants is a cause of hyperprolactinemia

TRUE

18

t or f: 50% of women with hyperprolactinemia will have a prolactinoma

TRUE (esp if prolactin levels are greater than 200 ng/mL)

19

t or f: most prolactinomas are macroadenomas

FALSE: most are microadenomas (NOTE: a majority of micro adenomas DO NOT enlarge)

20

t or f: treatments is NOT necessary for hyperprolactinemia with or without microadenoma unless the pt desires to get pregnant

TRUE - also true if the estrogen levels are low (should treat b/c of increased risk of osteoporosis)

21

the most common symptoms of hyperprolactinemia are what two things?

galactorrhea and amenorrhea

22

what is the modality of choice for diagnosis of pituitary adenomas?

MRI

23

what is the DOC for women with a prolactin secreting microadenoma who wan to conceive?

bromocriptine

24

what is the DOC for reducing prolactin levels and shrinking tumors?

cabergoline (dopamine agonist)

25

t or f: pregnancy increases the likelihood that prolactin levels will decrease or become normal over time

TRUE

26

t or f: cabergoline is more effective and better tolerated than bromocriptine

TRUE

27

what is that protocol for bromocriptine use once the pt becomes pregnant?

d/c as it crosses the placenta although not a proven teratogen

28

what are some common side effects of bromocriptine? how can they be reduced

n&v (reduce by administering vaginally); orthostatic hypotension