Question

A 27 year old G2P2A0 at six weeks postpartum presents with depressed mood, dry skin, and problems breast feeding. Though she was initially able to breastfeed without difficulty, she has been unable to produce adequate lactation to feed her daughter, and lately her milk has completely ""dried up."" Her most recent pregnancy was uneventful, but delivery of her healthy female infant was complicated by severe uterine atony requiring multiple blood transfusions and treatment with prostaglandins. On physical examination, the patient has a blood pressure of 90/64. Skin tenting and fine wrinkles are noted around the eyes and mouth. There are diminished deep tendon reflexes with a prolonged relaxation phase. Laboratory evaluation is notable for a hemoglobin of 10.5 g/dL, thyroid stimulating hormone of 0.1 U/mL, and prolactin of 2 ng/mL (normal 0-20 ng/mL). Which of the following is the most likely diagnosis in this patient?

A. Sheehan
B. Graves
C. Uterine rupture
D. Hashimoto thyroiditis
E. Pituitary prolactinoma

Answer 1

The most likely diagnosis in this patient is Sheehan syndrome, a condition that occurs when there is significant blood loss during childbirth, leading to damage to the pituitary gland and decreased production of hormones.

Correct optiom is A.

Step-by-step explanation:

The most likely diagnosis in this patient is Sheehan syndrome. Sheehan syndrome is a condition that occurs when there is significant blood loss during childbirth, leading to damage to the pituitary gland. This damage can result in decreased production of hormones, including prolactin, which is responsible for milk production. Symptoms of Sheehan syndrome can include depressed mood, dry skin, and problems with breastfeeding.