Hormones & Endocrinology Case Study
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 (1 point)
What hormones are of LEAST concern in this person?
insulin
GH
GnRH
TSH
Question 2 (1 point)
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 (1 point)
Why is she small in stature?
Low TSH
Low GH
Low ACTH
Question 4 (1 point)
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 (1 point)
What hormones are of greatest concern in this person?
GH
ACTH
Prolactin
GSH
Question 6 (1 point)
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
Hormones & Endocrinology Case Study
Question 7 (1 point)
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 (1 point)
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 (1 point)
Frequent urination (polyuria) with excessive drinking is called
diabetes
hypothyroid
hypocortisol
hypogonad
Question 10 (1 point)
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 (1 point)
What most importantly distinguishes between diabetes mellitus and diabetes insipidus?
glucose in the urine
protein in the urine
aldosterone levels
concentration of the urine
