Question

Fifty-one-year-old Dennis, an auto mechanic, waited impatiently in the emergency room at 7:30 am on Sunday morning. He reported to the ER staff that he had been having constant moderate-to-severe headaches. The ER nurse charted that Dennis was experiencing retrobulbar headaches. While providing more details of his medical history to the ER staff, he also reported that for the past 8 years he had decreased libido. For the last 3 years, he suffered from chronic fatigue, cold intolerance, decreased beard growth and poor tanning of the skin.  

The ER staff continued taking an in-depth medical history only to find that Dennis noted an increase in his shoe size and an increase in his ring size. His nose, lips, tongue and jaw also increased in size.

The emergency room staff proceeded with a physical examination. The following facts were charted:

1. The patient’s blood pressure was 100/60 mm Hg while lying down and 80/50 mm Hg while standing.

2. His skin was dry and pale and appeared thickened.

3. Dennis only had a small amount of pubic and axillary hair.

4. Dennis had smaller than normal testes and the testes were softer than normal.

5. His nose, mandible, zygomatic bones, and lips were prominent.

6. His tongue was large along with the soft tissue of his hands and feet.

7. He exhibited bi-temporal hemianopsia; his left pupil was dilated and his left eye deviated laterally.

Short Answer Questions

List the findings in the patient history and physical exam that seem to be abnormal. Review the functions of each hormone studied so that you can group abnormal findings for this case that relate to one hormone.  

There are multiple hormones involved here. Identify each hormone involved. Also indicate whether the data suggest an increase or a decrease in hormone secretion. Use the table below as a guide.

Hormone	Inc/Dec	Abnormalities

Answer 1

Ans.-

1) - The patient blood pressure was 100/60 mmHg while lying down and 80/50 mmHg while standing are the decreased blood flow makes it difficult to achieve and maintain erection . High blood pressure can also interfere with ejaculation and reduce sexual desire .

2) - His skin was dry and pale and appeared thickened are due to decrease of blood flow or seen in aged person dead cells are collecte together like side of the foot bone albow bone and a hormonal effect .

3) - small amount of pubic and axillary hair effect of rising levels of androgens in males Pubic hair differs from other hair on the body and is a secondary sex characteristic. Many cultures regard pubic hair as erotic, and in most cultures pubic hair is associated with the genitals,There are many potential causes of pubic hair loss or axillary example include excessive hair removal, hormonal changes, alopecia, and side effects of medical treatments.

4) - Dennis had smaller than normal testes and the testes were softer than normal. testicle size affect testosterone and fertility.

• producing sperm for reproduction
• secreting the male hormone testosterone, which is important in the development of male physical characteristics and sex drive

Low levels of testosterone are associated with a higher risk of cardiovascular disease.

It is most cause in hypogonadism in male .One in particular is called male hypogonadism. Hypogonadism is a condition in which the body doesn’t produce enough testosterone to help ensure proper development of male characteristics, such as the penis, testicles, and muscle mass.

5) - His nose, mandible, zygomatic bones, and lips were prominent effects of age, sex, weight, height, facial size , also effect on sometostatin during the dysfunction of libido.

6) - His tongue was large along with the soft tissue of his hands and feet. Due to hyper secretion of growth hormone .Acromegaly is a rare, slowly progressive, acquired disorder that affects adults. It occurs when the pituitary gland produces too much growth hormone. The pituitary gland is a small gland located near the base of the skull that stores several hormones and releases them into the bloodstream as needed by the body. These hormones regulate many different bodily functions.

Symptoms of acromegaly include abnormal enlargement in bones of the hands, arms, feet, legs, and head. Enlargement of the bones in the jaws and in the front of the skull are typically the most apparent bony changes. Acromegaly may also cause thickening of the soft tissues of the body, including the heart, lips, and tongue. When the disease affects children prior to the end of puberty, excess growth hormone can lead to accelerated growth and tall stature, known as gigantism. If untreated, acromegaly can potentially cause serious illness and life-threatening complications.Overgrowth (hypertrophy) of bone and enlargement of cartilage in the joints may result in inflammation and gradual degeneration of involved joints (osteoarthritis). Joint and muscle pain (arthralgia and myalgia) often develops, especially affecting the large joints such as the knees, shoulders, hands, wrists and hips.