determine
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Lady develop severe PPH (post partum heamorrage), she present after 6 wks with fatigue an inability to breast feed (absence of breast milk). All will be decreased except:
a. Prolactin
b. TSH
c. LH
d. T4
Answer is give 4 but I couldn`t understand why. Any help?
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| srf
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severe heamorrage has caused pitutary apoplexy, leading to hopothyroidism so T4 is needed.
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| achilles
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srf, severe post partum hemorrhage has not caused pituitary apoplexy but it sure must have caused sheehans syndrome caused by hypotension due to the hemorrhage and inability to lactate is one of the first signs.
pituitary apoplexy occurs in an alreeady existing pituitary adenoma.
i dont know why t4 wont be decreased though...it should be !! when TSH is decreased, t4 should be decreased too. i am not sure about prolactin though. i would have gone for A as the answer.
anyone can help us ?
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| determine
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look at this answer :
"this is a case of sheehan's syndrome which causes hpopituitarism. prolactin, TSH, will be decreased. t4 will remain elevated because of a longer half life. "
I'm not still %100 convinced, but maybe it helps you achilles.
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| srf
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thanks achilles
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| achilles
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thats right determine...i have read that somewhere about t4 having a longer half life...but had forgotten it and so obviously could'nt apply it ...thanks determine for the info. this was a good question !!
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