A 21-year-old woman experiences abruptio placentae with severe bleeding during the delivery of a term fetus. Five months later, she presents with profound lethargy, pallor, muscle weakness, failure of lactation and amenorrhea. Which of the following pathologic findings is expected in this patient?
- Given clinical features suggests the diagnosis of Sheehan syndrome. SHEEHAN SYNDROME - Caused d/t postpaum ischemic necrosis of anterior pituitary. - Occurs after severe hypotension induced by postpaum hemorrhage. - The pituitary is paicularly susceptible at this time because its enlargement during pregnancy renders it vulnerable to reduction in blood flow. - C/F of panhypopituitarism : Pallor (d/t decreased MSH) Hypothyroidism (d/t decreased TSH) Failure of lactation (d/t decreased prolactin) Adrenal insufficiency (d/t decreased ACTH) Ovarian failure (d/t decreased FSH and LH). - None of the other choices lead to this constellation of hormone deficiencies.
Atrophy of the endocrine pancreas
Autoimmune destruction of the adrenal coex
Infarction of the pituitary
Pituitary prolactinoma
Miscellaneous