Final Exam: Endocrine system case studies
UNIT XI: Endocrine Function, Metabolism, and Nutrition
Case Studies

Case 1
B.J. is a 54-year-old attorney who for several months has been experiencing generalized headaches that have responded poorly to nonnarcotic analgesics. He is also experiencing visual disturbances including blurred vision and double vision. On questioning, B.J. reports that he has gained 20 pounds over 2 years despite no change in activity or eating patterns. About his weight gain, B.J. jokes, “I guess it’s all in my feet. I had to buy new shoes, and my shoe size went from a size 10 to a size 12.” It was determined that B.J. should have a CT scan of his head to assess for a pituitary adenoma resulting in the hypersecretion of growth hormone.

Discussion Questions
1. What information from the above scenario would support this possible etiology?
The headaches is a possible symptom leading to the pituitary adenoma as this could be putting intracranial pressure on the brain. With also what it appears to be edema in the limbs is another indicator of the hypersecretion. With the use of nonnarcotic analgesics indicates that it has not improved the condition.
2. What other signs or symptoms might be apparent if B.J. does indeed have a pituitary adenoma?
Another sign that could indicate the pituitary adenoma is the blurred and double vision. This means that it could possibly be compression on the optic nerve that is causing the altered vision. There could be a possibility of a tumor growing from the hypersecretion of the growth hormone, causing the blurred/double visions and headache to possibly get worse.
3. B.J. is diagnosed with pituitary adenoma and undergoes a transsphenoidal hypophysectomy to remove the tumor. After surgery, he has huge urinary outputs of 500 to 600 ml/hr. What is the most likely cause of his high urine output? What other