Your friend is concerned because although she has never been pregnant, her breasts are producing milk. When she went to the doctor, he sent her to the MRI lab for a brain scan. She was too embarrassed to ask the doctor why. What do you tell her?

Question

A.  "They were actually scanning your thyroid gland, not your brain. Are you getting enough iodine in your diet?"
B.  "The MRI technician must have mixed up your patient records. He should have done a thoracic scan instead."
C.  "LH and FSH from the posterior pituitary stimulate milk production. The doctor wants to rule out excess levels of estrogen in the pituitary stalk."
D.  "Prolactin from the anterior pituitary stimulates milk production. The doctor probably wants to rule out a pituitary tumor."

Clarify Question
What is the key concept addressed by the question?
What type of thinking is required?

Gather Content
What do you already know about the pituitary gland? What other information is related to the question?

Choose Answer
Given what you now know, what information is most likely to produce the correct answer?

Reflect on Process
Did your problem-solving process lead you to the correct answer? If not, where did the process break down or lead you astray? How can you revise your approach to produce a more desirable result?

Answer 1

D.  "Prolactin from the anterior pituitary stimulates milk production. The doctor probably wants to rule out a pituitary tumor."

Clarify Question
What is the key concept addressed by the question?
        · What could cause milk production not associated with pregnancy?
What type of thinking is required?
            o This is an evaluate question because you have to consider each potential cause of non-pregnancy related milk production.

Gather Content
What do you already know about the pituitary gland? What other information is related to the question?
        · The pituitary gland produces prolactin, which stimulates milk production in mammals. Estrogen and progesterone are also involved in the regulation of milk production, but they do so by blocking the release of prolactin. The doctor sent the patient for a brain scan, and since estrogen and progesterone are produced in the ovaries, he/she must not be concerned about any problems with the ovaries in producing this milk production.

Choose Answer
Given what you now know, what information is most likely to produce the correct answer?
        · One of the potential responses discussed scanning the thyroid gland, potentially because the patient is not getting enough iodine. Lack of iodine leads to goiter, or an enlarged thyroid gland, which is not the symptom of the patient. LH and FSH do not stimulate milk production, but regulates ovulation in females. Thus, the most likely reason for the MRI brain scan is to rule out a pituitary tumor since prolactin, which stimulates milk production, is produced in the anterior pituitary gland.

Reflect on Process
Did your problem-solving process lead you to the correct answer? If not, where did the process break down or lead you astray? How can you revise your approach to produce a more desirable result?
       · Answering this question correctly depended upon evaluating each potential response concerning your friend’s MRI brain scan. If you got the answer correct, great! If not, which answers did you choose? Did you think that since LH and FSH regulate ovulation that they are female sex hormones that would affect milk production as well? Did you think the technician should have done a thoracic scan to look at the ovaries since they produce estrogen and progesterone, which is also involved in milk production? Remember that estrogen and progesterone, which are high during pregnancy, inhibit the release of prolactin, and thus would prevent mild production, not stimulate it.