Snapshot A 26-year-old woman, 5 days post vaginal delivery, presents to her child's pediatrician with a complaint that she is unable to breast feed her child. History reveals a vaginal delivery complicated by postpartum hemorrhage. Introduction Failure to lactate following postpartum hemorrhage result of pituitary infarction that occured as a result of hypovolemic shock pituitary normally very enlarged during pregancy due ↑ lactotrophs no corresponding ↑ blood supply hypopituitarism results in ↓ prolactin secretion Presentation Symptoms sudden cessation of lactation loss of prolactin fatigue loss of TSH loss of pubic and axillary hair loss of LH/FSH anorexia Evaluation Only clinically significant cause of lower than normal serum prolactin levels
QUESTIONS 1 of 3 1 2 3 Previous Next Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK (M1.EC.17.4707) A 32-year-old female presents to her obstetrician 3 weeks postpartum for failure to lactate. Of note, she has been unable to tolerate cold environments since the birth of her child. Review of systems is positive for fatigue, lightheadedness, and a 3-pound weight gain over the last 3 weeks. Her delivery was complicated by placenta accreta with postpartum blood loss. Her newborn infant is doing well on formula. She denies any personal or family history of thyroid disease. Physical exam is overall unremarkable. On a panel of hormone testing, which of the following levels is most likely to be normal in this patient? QID: 108430 Type & Select Correct Answer 1 Antidiuretic hormone 39% (89/226) 2 Aldosterone 33% (74/226) 3 Cortisol 8% (17/226) 4 Luteinizing hormone 8% (18/226) 5 Thyroid hormone 9% (21/226) M 1 Question Complexity D Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 2 Review Tested Concept Review Full Topic Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK