PAEA Surgery End Of Rotation (EOR) Practice Exam

What is the primary medical treatment for prolactinoma?

1. Cabergoline

2. Levothyroxine

3. Bromocriptine

4. Somatostatin

The correct answer is: Bromocriptine

The primary medical treatment for prolactinoma is cabergoline, which is a dopamine agonist that works effectively to reduce prolactin levels and tumor size. Cabergoline is preferred due to its longer half-life compared to bromocriptine, allowing for less frequent dosing and improved patient compliance. It stimulates dopamine receptors, which leads to decreased prolactin secretion from the pituitary gland. While bromocriptine is another effective treatment for prolactinoma and may have been a common choice in the past, cabergoline’s efficacy and convenience have made it the first line of treatment in most cases. This highlights the importance of recognizing current treatment guidelines and drug preferences in clinical practice. Levothyroxine is primarily used for hypothyroidism and does not have a direct role in managing prolactin levels or prolactinoma. Somatostatin, while useful in treating certain types of tumors such as growth hormone-secreting pituitary adenomas, is not indicated for prolactinomas. Understanding the primary treatment options, their mechanisms of action, and the rationale behind choosing one agent over another is crucial for effective management of prolactinomas in clinical practice.