The Man with Gynecomastia — Cracking the Dopamine Code
from Master USMLE Hosted by Dr. Amin Afrasiabi
In this Master Series episode, we unpack a high-yield case of antipsychotic-induced hyperprolactinemia. A twenty-nine-year-old man presents with low libido, erectile dysfunction, and gynecomastia after starting risperidone. What seems like a straightforward side effect opens the door to mastering the four dopamine pathways—mesolimbic, mesocortical, nigrostriatal, and tuberoinfundibular. This episode breaks down: How dopamine blockade leads to hyperprolactinemia The distinct clinical roles of each dopamine pathway How to approach antipsychotic side effects on Step 2 CK The management of risperidone-induced endocrine symptoms By the end of this episode, you’ll be confident in navigating dopamine physiology, choosing the right antipsychotic alternatives, and avoiding classic exam pitfalls. Stay focused. Study smart. And keep mastering medicine.
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