4 Weeks Of Spontaneous in Medicine / Internal Medicine — 34yo Woman | Endocrinology | SMLE Q#11263
SMLE Question #11263
Medicine / Internal Medicine
Endocrinology
Objective: OBJ-ADDISON-DOSE-1
Last updated: February 2026
A 34-year-old woman presents with 4 weeks of spontaneous bilateral milky nipple discharge. She stopped breastfeeding 2 years ago. She has had amenorrhea for 2 months after previously regular 28-day cycles. She denies headaches, visual changes, and use of antipsychotics or other new medications. Breast examination shows no masses or skin changes, with non-bloody milky discharge expressed from both nipples. Neurologic examination, including visual fields, is normal. What is the most appropriate initial investigation in the evaluation of this patient?
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