Review Question - QID 109608

A 37-year-old woman presents to her primary care physician for bilateral nipple discharge. She has observed a milky discharge coming from her nipples for the past month. She has felt fatigued lately and has experienced decreased libido. She also endorses headaches that typically resolve by the middle of the day and a 5-pound weight gain this past month. The patient has a medical history of obesity, schizophrenia, and constipation. Her temperature is 99.5°F (37.5°C), blood pressure is 145/95 mmHg, pulse is 60/min, respirations are 15/min, and oxygen saturation is 98% on room air. On physical exam, you note an obese, fatigued-appearing woman. A dermatologic exam reveals fine, thin hair over her body. A cardiopulmonary exam is within normal limits. A neurological exam reveals cranial nerves 2-12 as grossly intact. The patient exhibits 1+ sluggish reflexes. Which of the following is the most likely diagnosis?