Medicine an Surgery notes

Apr 24th, 2015
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Benha University Hospital, EgyptEmail: elnashar53@hotmail.com1. Prolactin2. TSH3. FSH & LH4. Estrogen5. Progesterone6. 17 OH progestrone7. Androgens (Total testosterone,DHEAS)It is secreted by:Mammotropic cells of the anterior pituitary.It is necessary for initiation & maintenanceof lactationReference values:Premenopuasal: <20 ng/mlPostmenopausal: <12 ng/mlConditions for detection ofPRLLate morning, fasting,After 60 min rest,Not in late follicular phase,2nd blood sample if the firstis raisedClinical significance:-Hyposecretion: rare. Pituitarynecrosis or infarction-Hypersecretion:Idiopathic, Physiologic,pharmacologic, pathologicCauses of HyperprolactinaemiaPhysiologicPharmacologicPathologicPregnancyMetclorpromideHypothalamic disordersLactationMethyldopaPRL secreting tumorExceriseReserpineHpothyroidismEatingCimetidineAddsions diseaseStressEstrogenChest wall diseaseMorphineChronic renal failureAlcholoic cirrhosisRelation between The level& the cause:> 100 ng/ml:60% pituitary tumor.> 300 ng/ml:100% pituitary tumorModest elevation can beClinical conditions associate withhyperprolactinaemia1. Galactorrhea.2. Oligomenorhea3. Hirsutism4. Anovulation5. Corpus luteum deficiency6. InfertilityHyperprolactinaemia withoutgalactorrhea: 66%1. Inadequatedetection2. Hypoestrogenicstate.3. Inadequateestrogenic orDiagnostic evaluationHistory & Examination: Exclude: Recent pregna

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