Medical MCQ - In the evaluation of a 26-year-old patient with 4 months of secondary amenorrhea, you order serum prolactin and b-hCG assays. The pregnancy test is positive, and the prolactin comes back at 100 ng/mL (normal <25 ng/mL in this assay). This patient requires

In the evaluation of a 26-year-old patient with 4 months of secondary amenorrhea, you order serum prolactin and b-hCG assays. The pregnancy test is positive, and the prolactin comes back at 100 ng/mL (normal <25 ng/mL in this assay). This patient requires

Routine obstetric care

Computed tomography (CT) scan of her sella turcica to rule out pituitary adenoma

Repeat measurements of serum prolactin to ensure that values do not increase over 300 ng/mL

Bromocriptine to suppress prolactin

Question Category:

Gynaecology & Obstetrics

Correct Answer:

Routine obstetric care

Description:

There is a marked increase in levels of serum prolactin during gestation to over 10 times those values found in nonpregnant women. If this woman were not pregnant, the prolactin value could easily explain the amenorrhea and further evaluation of hyperprolactinemia would be necessary. The physiologic significance of increasing prolactin in pregnancy appears to involve preparation of the breasts for lactation.

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