Crystal is a 16 year old girl brought by her mother to their family physician. C

Question

Crystal is a 16 year old girl brought by her mother to their family physician. Crystal’s main concern for this visit is a failure to exhibit menarche (the onset of her first menstrual cycle). Crystal is anatomically normally developed for a pre-pubertal female. While pregnant with Crystal, her mother had an amniocentesis performed. Crystal’s karyotype is normal female. Six years ago, Crystal and her father sustained whiplash injuries when their car was hit from behind when they were stopped at an intersection. Shortly after the accident, Crystal experienced periodic vision disturbances found to be due to swelling at the area of the sella turcica and optic chiasm. The swelling and visual disturbances had resolved within one month after the accident. At her current examination, Crystal denies any visual disturbances. Crystal appears to have an adequate amount of body fat to support pubertal development. However, she is quite short in stature. She was progressing normally on her pediatric height charts until her automobile accident. Since that time, her growth curve readings have plateaued.

Question: Could Crystal’s automobile accident six years ago have impacted these hormone(s)? Explain.

Explanation / Answer

Answer:- Yes, Crystal’s automobile accident six years ago could have impacted these hormones.

It is mentioned, as Crystal is anatomically normal normally developed for a pre-pubertal female and her karyotype is also normal then there must be a hormonal problem as she fails to exhibit menarche. Again she is quite short in stature also shows a growth hormone problem. Now as Crystal undergone a whiplash injury six years ago, kind of traumatic brain injury. It could cause damage to her pituitary gland which is a significant gland that produces and regulates many important hormones such as hormones for growth and sexual function. As such, any injury that causes damage to the pituitary can have significant and permanent implications for the victim's quality of life as happened in the case of Crystal. Also, shortly after the accident, she experienced periodic vision disturbances found to be due to swelling at the area of the sella turcica and optic chiasm due the pressure exerted by enlarged pituitary gland. This swelling and visual disturbances had resolved within one month after the accident as the size of the gland became normal. However an automobile accident six years ago have damaged the part of pituitary gland in turn reduces or compromises the production of growth hormone and sex hormones.

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