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Old 07-09-2015
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Default Repeated USMLE Questions 12

A 33 year-old woman presents to her physician complaining of fatigue, general muscle aches, weight gain, irregular menstrual cycles and milky discharge from both breasts for 3 months. Her vital signs are pulse 64/min, blood pressure 123/88 and temp 96.3. Her physical examination reveals galactorrhea of both breasts and dry skin.
Her lab results are as follows:
Thyroid stimulation hormone (TSH): 23 uU/ml
Prolactin level: 55ng/ml
What is the best first step in management of this patient?
A- Repeat lab tests
B- Start levothyroxine therapy
C- Start estrogen therapy
D- Start anti-dopamine therapy
E- MRI of the pituitary gland
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