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NBME 23 Answers

nbme23/Block 3/Question#23

A pregnant 28-year-old woman is found to have ...


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submitted by mousie(128),

Your pituitary lactotrop cells hypertrophy during pregnancy to produce increasing amounts of prolactin - part of the pathophysiology of Sheehan's syndrome... increased blood loss during delivery can cause ischemic necrosis of pituitary

tinydoc  I thought the elevated Estrogen and progesterone depress the function of Prolactin until delivery. I guess you needed to know that it decreases its function by downregulating receptors or something as opposed actually decreasing the prolactin production. I picked gonadotrophs. This was a fair question but I reasoned it out and arrived at the wrong conclusion. +3  
maxillarythirdmolar  Specifically, the estrogen is stimulating lactotrophs as progesterone is preventing the prolactin from actually working on the breasts. So it's the estrogen that is stimulating the lactotrophs to grow, and you would see the effects of this growth if it weren't for the progesterone preventing the action of prolactin (their secretory product) on the breasts. +6  

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submitted by haozhier(0),

I chose corticotrope because I thought during pregnancy women have more cortisol. Can anyone explain it for me? Thanks!