Obstetric emergencies: Sheehan syndrome: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Obstetric emergencies: Sheehan syndrome

Sample item

A woman who had severe PPH with shock 6 months ago has failure of lactation, amenorrhoea and loss of axillary hair. What is the first hormone deficiency to manifest?

AVasopressinBTSHCACTHDProlactin

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Prolactin

Sheehan syndrome is postpartum pituitary necrosis. Failure of lactation (prolactin deficiency) is the earliest feature, followed by loss of gonadotrophins, then TSH and ACTH. Treatment is hormone replacement, giving hydrocortisone before thyroxine.

Option by option

A. Vasopressin
Diabetes insipidus is uncommon in Sheehan syndrome.
B. TSH
TSH deficiency occurs later.
C. ACTH
ACTH deficiency occurs late but is life-threatening.
D. Prolactin (correct)
Correct. Failure of lactation is the earliest sign.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this OBG question

What is the answer to this OBG question?

The best answer is D, Prolactin. Sheehan syndrome is postpartum pituitary necrosis.

Why is "Vasopressin" not the answer?

Diabetes insipidus is uncommon in Sheehan syndrome.

Why is "TSH" not the answer?

TSH deficiency occurs later.

Why is "ACTH" not the answer?

ACTH deficiency occurs late but is life-threatening.

What concept does this question test?

It tests Obstetric emergencies: Sheehan syndrome in OBG. Failure of lactation (prolactin deficiency) is the earliest feature, followed by loss of gonadotrophins, then TSH and ACTH. Treatment is hormone replacement, giving hydrocortisone before thyroxine.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Obstetric emergencies: Sheehan syndrome?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.