saadtazjam
Forum Elite
Topics: 9
Posts: 160
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Kap Q :14 yr old boy has gynecomastia,asymetric enlargement of breast tissue starting on the left and then on the right over 6 months.Mild Tenderness+ROS:Headache relieved by Aspirin at times he needs to lie down.
O/E:Boy is at tanner 4,Bilat Breast enlargementLeft larger than right inaddition to milky disacharge Next step in management of this patient
A)Obtain Serum Prolactin level
B)Testicular scan
C)Reassurance
D)Refer to surgeon
E)Search for Exo.Estrogen
F)Start Anti estrogen Drug
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| study_ing
Forum Fanatic
Topics: 180
Posts: 2,511
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gynacomastia in at puberty is accepatble. butthis pt has galactorrhea. id probably go for A.
but then its gotta be more dif than that, right 
hmm
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| robin082006
Forum Hero
Topics: 471
Posts: 5,125
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yeah I agree with you, A
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| tolito
Forum Fanatic
Topics: 119
Posts: 2,170
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quite an unusual presentation...galactorrhoea.
i also go for A.
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| Guptashutosh
Forum Elite
Topics: 35
Posts: 354
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if the q had an option MRI brain in addition to the above options, what will u do 1st mri or serum prolatin level
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| Javed
Forum Junior
Topics: 16
Posts: 61
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given a choice bw mri n s.prolactin i wud go 4 s.prolactin 1st. coz its easier n to do than mri. n moreover if v r suspecting pituitary adenoma secreting prolactin than that wil b elevated.if its not,then v wud search for other other causes of galactorrhea
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| Sea_gull
Forum Elite
Topics: 32
Posts: 179
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There is four indications for measuring serum prolactin level
- Galactorrhea
- Enlarged sells turcica
- suspected pituitary tumor
- Hypogonadotropic hypogonadism
Best of luck
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| lucci
Forum Senior
Topics: 35
Posts: 52
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Serum prolactin shoukd be the next step.
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