path/endo9 - milestones

[ArchivalUser]

A 29-year-old primigravida who received no prenatal care has marked vaginal bleeding after the onset of labor at 38 weeks gestation. Cesarean section is performed and a lacerated low-lying placenta is removed. She remains hypotensive for 6 hours and requires transfusion of 12 packed RBC units. Postpartum, she becomes unable to breast-feed the infant. She does not have a resumption of normal menstrual cycles. She becomes more sluggish and tired. Laboratory findings include hyponatremia, hyperkalemia, and hypoglycemia. Which of the following pathologic lesions is she most likely to have had following delivery?
A Bilateral adrenal hemorrhage
B Pituitary necrosis
C Subacute thyroiditis
D Metastatic choriocarcinoma
E Insulitis

[ArchivalUser]

Bilateral adrenal hemorrhage

[ArchivalUser]

B Pituitary necrosis
shehan's syndrome

[ArchivalUser]

B.

[ArchivalUser]

B) CORRECT. She has Sheehan syndrome from post-partum anterior pituitary necrosis, leading to loss of pituitary hormones, including gonadotrophic hormone deficiency. The pituitary enlarges in pregnancy, which makes its blood supply more tenuous, and the pituitary is more susceptible to necrosis from events that lead to hypotension