Question
A 35-year-old lady is diagnosed to have post-partum hypopituitarism. The correct order of hormone substitution in her case would be :
The correct answer is
Glucocorticoids, thyroxin, oral contraceptives
Post-partum Hypopituitarism Hormone Substitution
Post-partum hypopituitarism, often due to Sheehan's syndrome, requires careful hormone replacement therapy. The order is critical to prevent life-threatening complications.
Priority of Hormone Replacement
The primary goal is to replace the most critical hormones first:
- Glucocorticoids: Essential for life. Deficiency causes adrenal insufficiency, which can lead to an adrenal crisis. This must be addressed first.
- Thyroxin: Treats hypothyroidism resulting from TSH deficiency. It should only be initiated after glucocorticoid replacement is stable, as thyroxin can worsen adrenal insufficiency if cortisol levels are insufficient.
- Oral Contraceptives (or Sex Hormones): Addresses hypogonadism due to LH/FSH deficiency. This replacement is important for long-term health but is less immediately critical than glucocorticoids or thyroxin.
Correct Substitution Order
Based on the priority, the correct sequence for hormone substitution is:
- Glucocorticoids: Replace cortisol deficiency.
- Thyroxin: Replace thyroid hormone deficiency.
- Oral Contraceptives: Replace sex hormone deficiency (estrogen/progesterone).
Therefore, the correct order is Glucocorticoids, thyroxin, oral contraceptives.
Was this answer helpful?
Important Questions from Adrenal Disorders
- Match the List I with List II and select the correct answer using the code given below the lists:
List I
(disease)List II
(signs)A. Conn syndrome 1. Anosmia B. Turner syndrome 2. Tetany C. Kallman syndrome 3. Lymphoedema D. Cushing syndrome 4. Avascular necrosis of hip
Code: - Which of the following test has maximum sensitivity for diagnosing Pheochromocytoma?
- A 26 year old lady has a Prolactinoma (microadenoma). The best modality of treatment for her condition is:
- Escape behaviour with paroxysmal occurrence is seen in:
- Hirsutism is seen in which of the following ?
1. Polycystic ovarian syndrome
2. Congenital adrenal hyperplasia
3. Hypothyroidism
4. Ovarian tumour
Select the correct answer using the code given below:
Need Expert Advice?
