A 31-year-old woman comes to clinic due to fatigue and abdominal pain for the last month since the birth of her child. She had an emergency cesarean delivery complicated by significant hemorrhage. The patient is unable to breastfeed. She reports occasional dizziness with standing. Blood pressure is 96/64 mmHg, and pulse is 96 bpm. The skin is dry, and the abdomen is not tender. The patient has sparse axillary and pubic hair Which of the following laboratory findings would be likely to be seen in this patient?
سؤال مجاني 1 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: E. ACTH: Low | Serum Sodium: Low | Serum Potassium: Normal
Postpartum hemorrhage followed by failure of lactation and loss of axillary/pubic hair means Sheehan syndrome (pituitary infarction), so this is secondary adrenal insufficiency with low ACTH. Aldosterone depends on renin-angiotensin, not ACTH, so it is preserved and potassium stays normal. Cortisol deficiency can still cause hyponatremia. High ACTH with hyperkalemia (C) is primary (Addison) disease, and high sodium (B) does not fit AI.
ليش كل خيار صح أو غلط
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A
ليش غلط
Pituitary infarction after postpartum hemorrhage (Sheehan syndrome) lowers pituitary hormones with a focus on ACTH, so ACTH is low, not normal.
✓ 5• Adrenal Insufficiency [Notes].pdf · p. 2 -
B
ليش غلط
Low ACTH fits, but AI causes hyponatremia, not high sodium, and hyperkalemia appears only in primary AI, not secondary.
✓ Step Up To Medicine 6th Edition 2024 (Adrenal).pdf · p. 10 -
C
ليش غلط
High ACTH with hyponatremia and hyperkalemia is primary adrenal insufficiency, where low aldosterone causes sodium loss and potassium retention; here ACTH is low.
✓ Step Up To Medicine 6th Edition 2024 (Adrenal).pdf · p. 10 -
D
ليش غلط
High ACTH occurs in primary AI; in secondary and tertiary AI, ACTH is low, which is this patient's pituitary (post-hemorrhage) problem.
✓ Step Up To Medicine 6th Edition 2024 (Adrenal).pdf · p. 10 -
E
ليش صح
This is secondary (pituitary) AI, so ACTH is low; aldosterone depends on renin-angiotensin, not ACTH, so potassium stays normal, and hyponatremia is listed among the common findings of adrenal insufficiency.
✓ Step Up To Medicine 6th Edition 2024 (Adrenal).pdf · p. 10
- المصدر
- Step Up To Medicine 6th Edition 2024 (Adrenal).pdf · p. 10
5• Adrenal Insufficiency [Notes].pdf · p. 2 - المحاضرة
- Adrenal Insufficiency · Endocrinology · Module B
- ظهر في
- Endo bank