Professional and Linguistic Assessments Board (PLAB) Practice Exam

Which clinical feature is characteristic of prolactinoma?

1. Amenorrhea with galactorrhea

2. Acne and hirsutism

3. Weight gain and edema

4. Night sweats and palpitations

The correct answer is: Amenorrhea with galactorrhea

The characteristic clinical feature of prolactinoma is amenorrhea with galactorrhea. Prolactinoma is a type of pituitary tumor that secretes excess prolactin, the hormone responsible for milk production. In women, elevated levels of prolactin can lead to amenorrhea, which is the absence of menstrual periods. This occurs because high prolactin inhibits the secretion of gonadotropin-releasing hormone (GnRH) from the hypothalamus, resulting in decreased secretion of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) from the anterior pituitary. The interference with normal hormonal balance disrupts ovarian function, leading to amenorrhea. Galactorrhea, which is the spontaneous flow of milk from the breast not associated with childbirth or nursing, can also occur due to the high levels of prolactin. This condition may present as a fluid discharge from the nipples, which is another direct manifestation of excess prolactin stimulation. The other choices present symptoms that are more associated with different hormonal imbalances or conditions, such as polycystic ovary syndrome (acne and hirsutism), hypothyroidism or heart conditions (weight gain and edema), and