At Samantha\'s first high school soccer game. Mr. & Mrs. Smith notice that their

Question

At Samantha's first high school soccer game. Mr. & Mrs. Smith notice that their 16 year-old daughter towers over her peers. Upon further examination they realize that her hands, feet and jaw all seem to be becoming abnormally large compared to others on her team. And, Mrs. Smith recently scheduled an eye appointment for Sam after she complained of double vision and headaches. Upon voicing their concerns to Sam's pediatrician. Dr. Jones orders a CT scan which reveals a tumor in her pituitary gland. a) Why did Dr. Jones order the CT scan? b) What accounts for Sam's symptoms and what is the diagnosis? c) What condition did Sam initially exhibit as a child? d) If not corrected what condition will she have as an adult? After several months of muscle weakness and two episodes of kidney stones, Gloria's doctor ordered blood work and a hip x-ray to find out what was causing the stones. It was determined that Gloria was suffering from an excess secretion of PTH. possibly due to a parathyroid gland tumor. Amazingly the surgeon was not able to locate the parathyroid glands on the posterior surface of the thyroid. a) Is it still possible that Gloria has a parathyroid tumor? Why/Why not? b) Which blood tests should be ordered to determine if it is a tumor of the parathyroid gland? c) Why was an x-ray ordered?

Explanation / Answer

1 (a)- CT scanning provides a good information if the tumor in pituitary or pituitary adenoma is big enough. Therefore, doctor generally suggests the CT scanning of brain, which will reveal if the case is Pituitary adenoma.

1 (b)- The patient has abnormal growth of her hands, feet and jaw, which is a symptom of release of more growth hormone from pituitary. It will take a CT scan if tumor is big, failing to identify may lead to diagnose the tumor through MRI scan. The further diagnosis is require to find the level of blood and urine levels of growth hormone and insulin-like growth factor-1, generally it occurs through glucose suppression test.

1 (c)- This casue acromegaly in Sam, which will exhibit enlarged organs like those that adults have.

1 (d)- If not treated, this will lead to failure or less functioning of pituitary in adults. That will cause for serious illness in adults. It will also affect the optic nerves and brain.

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