امرأة عمرها ٣٤ سنة عندها تأخر في الدورة، وإفراز حليب من الثدي، وصداع، وضعف في الرؤية الجانبية. ليست حاملاً. البرولاكتين مرتفع جداً. ما الأرجح؟

A 34-year-old woman has missed periods, breast milk discharge, headaches and reduced peripheral vision. She is not pregnant; prolactin is very high. What is most likely?

1. Hypothyroidism alone
2. A prolactin-secreting adenoma
3. Simple polycystic ovary syndrome
4. Early menopause

Answer: B) A prolactin-secreting adenoma. High prolactin with amenorrhoea, galactorrhoea, headache and bitemporal field loss (chiasmal compression) indicates a prolactinoma, usually treated with cabergoline.