Chapter 32, Problem 1RE

A.

Summary Introduction

To describe: The findings suggested by man's clinical features, MRI, and laboratory findings.

Introduction: A pituitary tumor is a tumor that develops in the pituitary gland that is found near the brain and can produce alterations in hormone levels in the body.

Explanation of Solution

A diagnosis of a pituitary tumor is quite evident from the MRI and the laboratory findings. As the tumor shows symptoms of increased growth hormones in the body, cancer can be localized towards the anterior portion of the gland. Vision modifications or headaches are the most characteristic symptoms. In some cases, hormones can also be modified, hindering the menstrual cycles, and producing sexual dysfunction.

B.

Summary Introduction

To describe: The reason related to the questions about weight change, polyuria and polydipsia, visual disturbance, and erectile dysfunction.

Introduction: The changes in menstrual cycles in women, erectile dysfunction, which is the inability to achieve or maintain an erection in men, and infertility, which is the disability to have children are the typical signs of the tumor.

Explanation of Solution

The patient is asked for the polyuria, polydipsia, and other symptoms to understand the nature of the tumor and to examine its location. Also, to rule out diabetes insipidus, which can be caused by a posterior pituitary tumor.

C.

Summary Introduction

To describe: The reason for the impaired glucose tolerance in the patient.

Introduction: Pituitary hormones play an indispensable role in regulating glucose metabolism. There are conditions like acromegaly and Cushing's disease, which are overtly associated with diabetes. Developing proof implies that prolactin, vasopressin, and oxytocin also use a subtle physiological role in glucose homeostasis.

Explanation of Solution

Glucose tolerance is impaired because of the receptor for insulin, which governs glucose uptake, allows the binding of growth hormone, which explains the case presented. As the growth hormone is secreted excessively; therefore, glucose intolerance is reported.

D.

Summary Introduction

To describe: The possible local effects of a large pituitary tumor.

Introduction: An Expansion of the pituitary gland is customarily due to a tumor. Still, it may be due to bleeding into the organ or association by some other disease, such as tuberculosis or sarcoidosis.

Explanation of Solution

The possible effects of local tumor enlargement can be varied and based mainly on location, yet it is generalized that excessive hormone secretion will occur along with extreme headaches. Significant symptoms will be based on which tissue and which hormone is secreted in a more considerable amount.