A 50-year-old female presents to your office complaining of headaches, pain in her joints, and enlarged...

A 50-year-old female presents to your office complaining of headaches, pain in her joints, and enlarged shoe, glove, and hat size. Physical examination is significant for a predominant jaw, increased soft-tissue in the palm and soul and a large tongue.

Laboratory workup is significant for hyperglycemia.

1. What lab tests would be ordered for this condition?

2. What treatments would be recommended for this patient?

3. If the patient would go untreated what would be the complications from this disorder or this condition?

Solutions

Expert Solution

The patient might be having acromegaly. It is a condition that occurs due to excess production of growth hormone by the pituitary gland secondary to pituitary tumour

1. The lab tests to confirm this condition includes, serum growth hormone levels. In addition to this we would like to send thyroid profile and cortisol levels to rule out the hypersecretion of these hormones.

MRI of the brain is often used to determine the size of the pituitary tumour

2. Treatment is either medical (only for limited time) or surgical (definitive)

Medical treatment includes growth hormone antagonist like pegvisomant or more commonly used drugs like octerotide (inhibits growth hormone secretion)

Definitive treatment is surgical resection of the pituitary tumour

3. If the condition is untreated, the patient goes to develop diabetes, hypertension, visual loss ( due to optic chaism compression by the tumour). Death is likely due to heart disease as the heart may be hypertophied and land in myocardial infarction

Hope this helps.... Thank you!!!

Sydney Mullin answered 1 year ago

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