A 29-Year-Old Woman Comes to the Office Due to Whitish

question 166

Multiple Choice

A 29-year-old woman comes to the office due to whitish nipple discharge, she also states that she has no menstrual periods for 4 months. The pregnancy test was negative. She also has increased fatigue and feels depression. she has a 10 kg as recent weight gain. The patient has had no headaches or vision changes. She has no prior medical problems and takes no medications. On physical examination, there is thinning of the outer third of the eyebrows. The thyroid is enlarged and nontender to palpation. Abdominal and pelvic examinations are normal. The skin appears dry. On lab tests there are elevated TSH and low thyroxine. an increase in prolactin is also detected. Which of the following is the most likely mechanism causing this patient's elevated prolactin level?

• A)Activation of lactotrophs by antithyroid peroxidase antibodies
• B)Binding of dopamine receptors by antithyroid peroxidase antibodies
• C)Inhibition of dopamine release by TSH
• D)Stimulation of lactotrophs by thyrotropin-releasing hormone (TRH)
• E)TRH-induced overproduction of dopamine
• F)TSH-mediated activation of lactotrophs

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