A woman with a pituitary adenoma has a bitemporal hemianopia and galactorrhoea, with a markedly raised prolactin. What is the first-line treatment?
Answer and explanation
Correct answer: D. A dopamine agonist such as cabergoline
- Step 1: A prolactinoma causes galactorrhoea and compresses the optic chiasm. Step 2. Dopamine agonists suppress prolactin and shrink most tumours, with surgery for failure or intolerance. Answer: A dopamine agonist such as cabergoline. Why not the others: Surgery is second line. Octreotide acts on somatostatin receptors, as in acromegaly. Hydrocortisone replaces cortisol and would not shrink the tumour.
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