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cpeedahsa
Century Club
Joined: 21 Apr 2007
Posts: 921
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 Posted: Sat Jul 14, 2007 7:00 pm Post subject: Re: prolactin |
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| Nick Raine-Fenning wrote: | | cpeedahsa wrote: | Prolactin- Female 0-20 ug/L(SI units) 1.9-25.9 ng/mL (Conventional units)
These are the reference values for Prolactin in the 25th edition of Harrison's Medicine. |
The problem with these values is that we do not use SI units!
Prolactin in the O&G literature, and as far as I am aware most of the medical literature, uses U/L for Prolactin and the following guide:
- > 450 U/L = raised
- > 1000 U/L = need to image the head
- > 1450 U/L = probable pituitary lesion
- > 4500 U/L = probable macroprolactinoma
Those are from memory so may be wrong but are in the ball park  |
I did go through some more literature and did find that these levels are correct( more or less) in Units. However the fact is that the system of international units (SI, Système Internationale d'Unités) is used in most medical and scientific journals and in clinical laboratories in many countries. However, clinical laboratories in some countries, including the United States, report results in conventional units
The problem arises is when we quote hormone levels without units--it is difficult to interpret them. Going by the rule book it would be ideal if the units are mentioned when hormones levels(or for that matter any other levels) are quoted (especially in case of parameters where different units are used by different people. |
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Nick Raine-Fenning
Course Director
Joined: 27 May 2006
Posts: 1854
Location: Nottingham
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| Posted: Sat Jul 14, 2007 7:41 pm Post subject: Re: prolactin |
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| cpeedahsa wrote: | | The problem arises is when we quote hormone levels without units--it is difficult to interpret them. Going by the rule book it would be ideal if the units are mentioned when hormones levels(or for that matter any other levels) are quoted (especially in case of parameters where different units are used by different people. |
You are quite right BUT and it is a big BUT you are taking a UK exam and this reflects UK practice so please do not swear ...
| cpeedahsa wrote: | | However the fact is that the system of international units (SI, Système Internationale d'Unités) is used in most medical and scientific journals and in clinical laboratories in many countries. However, clinical laboratories in some countries, including the United States, report results in conventional units. |
Only joking of course but all key texts in the UK report Prolactin in U/L or with values in the hundreds and thousands. |
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cpeedahsa
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Joined: 21 Apr 2007
Posts: 921
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| Posted: Sat Jul 14, 2007 8:07 pm Post subject: |
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| Nick Raine-Fenning wrote: | Question 14
You are asked to see a woman with secondary amenorrhoea and to review the results of the tests undertaken the previous month. Unfortunately her dog at the envelope with your letter in that outlined the findings! What uis the likely diagnosis.
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I still think it is menopause
I guess the clue in this question is tests undertaken previous month.
My thinking- Very unlikely that it is pregnancy--as it is usually ruled out (or diagnosed) by a simple pregnancy test(which would indeed be the first investigation done in any case of secondary amenorrhea and with the fastest results . We would not need a month to diagnose pregnancy. |
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Nick Raine-Fenning
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Joined: 27 May 2006
Posts: 1854
Location: Nottingham
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| Posted: Sat Jul 14, 2007 8:14 pm Post subject: |
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| Maybe not to make a diagnosis but to allow the Royal Mail time to deliver |
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Nick Raine-Fenning
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Joined: 27 May 2006
Posts: 1854
Location: Nottingham
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| Posted: Sat Jul 14, 2007 8:20 pm Post subject: |
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OK - I can see that you are in pain so here is an alternative question / view.
Extra 'make the point' question
You are asked to see a 29-year woman with secondary amenorrhoea ................................................... full stop / the end / no more info |
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cpeedahsa
Century Club
Joined: 21 Apr 2007
Posts: 921
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| Posted: Sat Jul 14, 2007 10:47 pm Post subject: |
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| Nick Raine-Fenning wrote: | OK - I can see that you are in pain so here is an alternative question / view.
Extra 'make the point' question
You are asked to see a 29-year woman with secondary amenorrhoea and to review the results of the tests undertaken the previous month. full stop / the end / no more info |
OK OK  -- This makes me think of Menopause all the more. Obviously at 29 years a diagnosis of Menopause(premature) would be definitely shocking! Who would not be?! |
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wolverine
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Joined: 16 Jan 2007
Posts: 394
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| Posted: Sun Jul 15, 2007 6:18 am Post subject: |
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| I don't think that if you see a 29 year old with 2 amenorrea your first diagnosis after pregnancy would be menopause though! It is still quite rare! More common cause would be PCOS. |
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cpeedahsa
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Joined: 21 Apr 2007
Posts: 921
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| Posted: Sun Jul 15, 2007 7:12 pm Post subject: |
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| Nick Raine-Fenning wrote: | | Maybe not to make a diagnosis but to allow the Royal Mail time to deliver |
I would have thought the urine pregnancy test results would be just readily available --to be told to the lady. In a normal scenario-- we would just ask the lady to wait for a minute after she gives the specimen for the pregnancy test.
Why do we need Royal mail to deliver pregnancy test results?  
Last edited by cpeedahsa on Mon Jul 16, 2007 2:13 am; edited 1 time in total |
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cpeedahsa
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Joined: 21 Apr 2007
Posts: 921
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| Posted: Mon Jul 16, 2007 1:40 am Post subject: |
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| Nick Raine-Fenning wrote: | Question 6
A 34-year woman is referred by her GP with secondary amenorrhoea. Examination is unremarkable but her test results show a raised prolactin (750 U/L) and testosterone (3.0 nmol/L). |
Hyperprolactinemia
High Prolactin (> 500U/L) and normal testosterone-Testosterone 0.5-3.5 nmol/l |
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cpeedahsa
Century Club
Joined: 21 Apr 2007
Posts: 921
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| Posted: Tue Jul 17, 2007 11:09 pm Post subject: |
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Nick, These were really really good set of questions!! Good exercise for my poor brain  |
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Nick Raine-Fenning
Course Director
Joined: 27 May 2006
Posts: 1854
Location: Nottingham
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| Posted: Wed Jul 18, 2007 4:00 am Post subject: |
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Just off to theairport for the Malaysia course.
I have not had time to put my answers up. I will try and do it by the weekend. A little more time for your minds! |
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cpeedahsa
Century Club
Joined: 21 Apr 2007
Posts: 921
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| Posted: Fri Aug 17, 2007 1:25 am Post subject: |
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| Nick Raine-Fenning wrote: | Just off to theairport for the Malaysia course.
I have not had time to put my answers up. I will try and do it by the weekend. A little more time for your minds! |
Nick, The final answers??  |
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