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): 23uU/ml Prolactin level: 55ng/ml What is the best next 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 http://medical-usmle.com/?p=812
