dimps
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A 48-year-old man comes to the clinic with symptoms of sexual dysfunction. He states that for the last year and a half, he has had a markedly decreased libido and trouble maintaining an erection. He has also occasionally noticed some milky-type of discharge from his nipples. He denies headaches, shortness of breath, or chest pain. He has had no abdominal or urinary symptoms. He has no significant past medical history and takes no medications. On physical examination, he is afebrile and has normal vital signs. His visual acuity, visual fields, extraocular movements, and pupillary response to light are normal. Remainder of neurologic examination is normal. Laboratory studies show a leukocyte count of 5,600/mm3, hematocrit 45%, platelets 230,000/mm3, glucose 100 mg/dL, creatinine 0.8 mg/dl, blood urea nitrogen 16 mg/dl, serum prolactin 1,000 ng/ml (normal <20 ng/ml). The next most appropriate step in management is
A. bromocriptine
B. mammography
C. a MRI of the brain
D. a MRI of the lumbar spine
E. sildenafil citrate
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| doc4mindia
Forum Guru
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C. a MRI of the brain
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| meg
Forum Guru
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agree
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| usmleasr
Forum Guru
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yeah...looks like microadenoma of pitutary since no pressure effects...
so we have to proceed with MRI and wheter we find one or not treat with bromocriptine..
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| dimps
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Posts: 446
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u all r correct
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