Endocrine System Case Study:
A 48-year-old man complaining of impotence sought medical attention.† Over the years, he experienced increasing difficulty with maintaining, and more recently, achieving an erection.† Further questioning revealed that he was shaving less frequently.† The patientís shoe size had increased from size 9C to 11EEE over the past 5 years and his dental plate had to be altered 3 times in 6 years.† The patient admitted to tingling of his fingers and joint pain.† Friends have remarked on changes in his physical appearance as well.†
On physical examination, he had coarse facial features with a bulbous nose and beetle-browed look.† The tongue was large and teeth spaced wide apart.† The hands and feet were enlarged and spadelike fingers.† The liver was enlarged. An MRI revealed a large tumorous mass near the pituitary.† Laboratory results revealed the following:
1.) Desribe the mechanism by which a peptide hormone initiates a cell response; a steroid hormone initiates a cell response. How are they the same? How are they different? Give a specific example of each and state their effect on the human body.
2.) What has caused the changes in the patientís facial features, hands, feet and liver?
3 .) Why did the physician measure the growth hormone level?
4 .) What is the normal effect of glucose on blood plasma GH level?
5 .) What is the most likely cause of the patientís impotence, and what hormonal abnormalities explain it?
6 .) What hormonal therapies might be useful for restoring gonadal function in this patient?
7 .) What molecule made in the hypothalamus might be therapeutically useful to this patient?
8 .) If the tumor is surgically removed, what physical changes would you expect to see in the patient?† If the anterior pituitary were removed along with the tumor, what would the consequences be for the patient?
9 .) What would be your final diagnosis of this patient?