In Galactorrhoea--amenorrhea syndromes, which is the investigation you should advise (apa from serum prolactin)?
(A) TSH (B) LH (C) hCG (D) Urinary ketosteroids
(A) Ans: A. TSH(Ref Harrison I9/e p2 p2267)Galactorrhea - amenorrhea syndromes:Serum prolactin &TSH advised.Laboratory diagnosis:Measure basal, fasting morning PRL levels - To assess hypersecretion.Normal PRL levels <20 ,ug/L.Markedly elevated PRL levels (>1000 ,ug/L) -Falsely lowered.Due to assay aifacts & aggregated circulating PRL forms.Sample dilution required for accurate measurement.Usually biologically inactive (macroprolactinemia).Measuring TSH and T4 levels - To exclude hypothyroidism.