Galactorrhea: The Daily PANCE Blueprint

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Galactorrhea: The Daily PANCE Blueprint

A 35-year-old female presents with spontaneous, bilateral, milky nipple discharge for the past month. She is not pregnant or breastfeeding. Review of medications reveals she recently started risperidone for bipolar disorder. Physical examination is unremarkable. Which of the following best explains this patient’s symptoms?

A. Prolactin-secreting pituitary adenoma
B. Elevated thyroid hormone levels
C. Estrogen deficiency
D. Chronic nipple stimulation
E. Medication-induced dopamine blockade

Answer and topic summary

The answer is E. Medication-induced dopamine blockade

Galactorrhea is defined as nipple discharge in non-breastfeeding women or men. Etiologies include hyperprolactinemia, primary hypothyroidism, medications (e.g., anti-psychotics, methyldopa, etc), chronic nipple stimulation, intra-ductal papilloma, and malignancy. Workup can include pregnancy tests, prolactin level, TSH level, and an ultrasound. A biopsy is needed if cancer is suspected at all.

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint Reproductive System ⇒ Breast Disorders ⇒ Galactorrhea

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