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There are no wise men or women in this world who can stop the death machine
It might conflict with their interests
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โญ๏ธ Sheehan Syndrome ๐คฑ๐ง
A postpartum hypopituitarism caused by ischemic necrosis of the anterior pituitary following severe obstetric hemorrhage.
โญ Classic Association = Postpartum hemorrhage + Failure to lactate
๐ Pathophysiology
โข Massive postpartum blood loss
โข Enlarged pituitary during pregnancy is vulnerable to ischemia
โข Anterior pituitary infarction
โข Multiple pituitary hormone deficiencies
๐ Classic Features
โข Failure to lactate (earliest sign)
โข Secondary amenorrhea
โข Loss of pubic/axillary hair
โข Fatigue and cold intolerance
๐ Hormones Decreased
โข โ Prolactin
โข โ FSH/LH
โข โ TSH
โข โ ACTH
๐ Investigations
โข Hyponatremia
โข Low pituitary hormones
โข MRI: Pituitary infarction or empty sella
๐ Management
โข Hydrocortisone FIRST โ ๏ธ
โข Levothyroxine replacement
โข Estrogen/progesterone replacement
โข Other hormone replacement as needed
โก Rapid Exam Clue
Postpartum hemorrhage + inability to breastfeed = Sheehan Syndrome
๐ง Memory Trick
โShe canโt feed the baby after she bled.โ
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โญ๏ธ- Types of Heart Block -โ
โ
๐ซHeart blocks occur when electrical signals from the atria to the ventricles are delayed or blockedโ
โ
๐ซThis leads to changes in the relationship between P waves and QRS complexesโ
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