BOF: 120
A 56-year-old male presents with a history of
impotence, decreased facial hair and a discharge from his nipples. A basal
plasma prolactin, taken at non-stressful venepuncture, is raised.
The patient also has gastro-oesophageal reflux disease
and hypertension and is on a number of drugs. Which of the following drugs
could cause a raised prolactin level?
a)
Omeprazole
b)
Metoclopramide
c)
Lisinopril
d)
Bendrofluazide
e)
Atenolol
Answer:
b)
The drugs that may increase prolactin levels are:
Phenothiazines, haloperidol, metoclopramide,
methyldopa, oestrogens, TRH
Which of the following diseases does not cause an
increase in prolactin levels?
a)
Non-secretory pituitary adenoma
b)
Chronic renal failure
c)
Hypothyroidism
d)
Sarcoidosis
e)
Chronic obstructive pulmonary disease
Answer:
e)
The diseases that may cause an increase in prolactin
levels are:
Prolactinoma, pituitary adenoma, pituitary stalk
section, hypothalamic disease, hypothyroidism, chronic renal failure,
sarcoidosis
Pituitary stalk section causes loss of inhibition of
prolactin production by dopamine. Similarly large pituitary adenomas can cause
loss of inhibition of prolactin production
Revision Tip
Revise hyperprolactinaemia KEYS
to SUCCESS in Medicine page 19-20
