Hyperprolactinaemia

Question 1

Pathophysiology?

Answer 1

TRH +
DOPAMIN -
+ BREAST,LACTATION
- OVARIES,ESTROGEN

Question 2

Physiological causes?

Answer 2

Preg, lactation, srvere stress, sleep, coitus

Question 3

Causes?

Answer 3

1. prolactinoma
2. co secretion of prolactin in tumours causing acromegaly
3. stalk compression
4. PCOS
5. Iry hypothyroidism
6. oestrogen tx
7. RF
8. LF
9. dopamine antagonist (metachlopromide,domperidone,antipsychotic)

Question 4

Clinical features?

Answer 4

Galactorrhea
Oligomenorrhea, amenorrhea 
Decrease libido
Sub fertility 
Symptoms of oestrogen and androgen def

Question 5

Ix?

Answer 5

Visual fields 
Exclude hypothyroidism and hypopitutarism
MRI pitutary 
> 5000 macrosdenoma of > 10 mm diameter 
>2000 micro

Question 6

Tx?

Answer 6

Dopamine agonist (cabergoline,bromacriptine)
Transphenoidal sx
Radiotherapy
Avoid effects of oes and testosterone def