What hormones are of greatest concern in person

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Reference no: EM133201116 , Length: 4 Pages

Case 1

A 14 year old girl is small in stature and appears younger than her age. She has not started menstruating, and her parents are concerned that she is not growing taller nor entering puberty. She has frequent headaches, and is having difficulty seeing the board at school, even
though she sits near the front of the room. She feels cold, even when the room is warm, and she is often constipated. Her parents are concerned. She is in the 30th percentile for height and weight, significantly below her peers.

Question 1

What hormones are of LEAST concern in this person?

insulin

GH

GnRH

TSH

Question 2

Laboratory analysis shows GH is low, ACTH is low, TSH is low, thyroid hormones are lower than normal, and FSH and LH are lower than normal for her age. A CT scan shows a mass in the pituitary near the hypothalamus.

What could account for her vision deficit?

The pituitary mass is near the optic chiasm

Unrelated to her endocrine condition

The thyroid is near the retina

Question 3

Why is she small in stature?

Low TSH

Low GH

Low ACTH

Question 4.

What could help her grow taller, if indicated?

ACTH replacement therapy

There is no treatment for this patient

GH replacement therapy

Case 2

A 50 year old male is experiencing fatigue, dizziness and headaches, with a rapid decline in his visual acuity. He treats his hypertension and type 2 diabetes with medications. His brow and jaw are enlarged (prognathism), his hands, feet and fingers are wide, and his wedding ring no longer fits. He is obese, with a deep voice.

Question 5

What hormones are of greatest concern in this person?

GH

ACTH

Prolactin

GSH

Question 6 

His laboratory tests show high blood glucose, high GH, high IGF1, normal prolactin, low testosterone. He has a pituitary mass seen on CT scan. The CT scans in both the 14 year old girl and the 50 year old man show a pituitary mass. Why are their symptoms not similar?

They are of different genders

They are of different ages

They are the same

One is producing GH, the other isn't

Question 7

What accounts for this patient's prognathism?

Low testosterone leads to increased bone growth and density

High growth hormone levels after epiphyseal plate closure cause thickening of bone structure

Low IGF-1 stimulates bone growth

Normal bone growth with aging

Question 8 

What is the diagnosis that best matches this patient's conditions?

Gigantism

Cushing's

Hypopituitarism

Acromegaly

Case 3

A 35 year old individual is drinking from a gallon water bottle. They feel dizzy on standing, complain of constant thirst and frequent urination. They don't like to take trips, since they may be too far from a bathroom when needed, and frequently get up at night to urinate.

Question 9

Frequent urination (polyuria) with excessive drinking is called

diabetes

hypothyroid

hypocortisol

hypogonad

Question 10

Laboratory shows dilute urine, with no glucose, protein or ketones. Blood glucose is normal,

ADH in the blood is undetectable.

type 2 diabetes mellitus

type 1 diabetes mellitus

neurogenic diabetes insipidus

nephrogenic diabetes insipidus

Question 11

What most importantly distinguishes between diabetes mellitus and diabetes insipidus?

glucose in the urine

protein in the urine

aldosterone levels

concentration of the urine

Reference no: EM133201116

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