Mehl. Sheenan 03-24 (1)

Question 1

M. Maternal pituitary grows in size during pregnancy due to incr.­ hormone production.

Answer 1

.

Question 2

M. Traumatic labor (e.g., C-section with loss of considerable blood) incr. risk of anterior pituitary ischemic infarction.

Answer 2

.

Question 3

M. what hormones decr?

Answer 3

Schools/resources will usually just teach that prolactin is ̄decr. But USMLE wants you to know that ALL hormones coming from the anterior pituitary are low.

Question 4

M. Textbook vignette is decr. ability to breastfeed due to decr. milk production following labor where BP was decr.

Answer 4

.

Question 5

M. NBME wants arrows for prolactin, ACTH, and TSH, aldosterone.?????

Answer 5

Decr. prolactin, ACTH, and TSH,
Incr. aldosterone.

Question 6

M. The incr.­ for aldosterone is weird, I agree. Take it up with NBME, not me. My suspicion is that decr. cortisol from decr. ACTH can lead to decr. basal blood pressure, where aldosterone could go ­up to compensate.

The patient is not going to have overt hyperaldosteronism with incr. Na+, decr. K+, incr. HCO3-, and incr. pH. It’s more that, in theory, basal level aldosterone could go­ up slightly to compensate.

Answer 6

.

Question 7

M. The vignette can mention fatigue, which reflects what?

Answer 7

decr. TSH (secondary hypothyroidism).