Mary Morgan has just been brought into the emergency room of City General Hospital. She is perspiring profusely and is breathing rapidly and irregularly. Her breath smells like acetone (sweet and fruity), and her blood glucose tests out at 650 mg/100 ml of blood. She is in acidosis. Which hormone drug should be administered, and why?
Kyle, a 5-year-old boy, has been growing by leaps and bounds; his height is 100% above normal for his age. He has been complaining of headaches and vision problems. A CT scan reveals a large pituitary tumor.
(a) Which hormone is being secreted in excess?
(b) What condition will Kyle exhibit if corrective measures are not taken?
(c) What is the probable cause of his headaches and visual problems?
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Key Concepts
Pituitary Gland and Hormone Secretion
Gigantism and Its Clinical Features
Effects of Pituitary Tumor on Surrounding Structures
How are the hyperglycemia and lipidemia of insulin deficiency linked?
List some problems that elderly people might have as a result of decreasing hormone production.
Aaron, a 42-year-old single father, goes to his physician complaining of nausea and chronic fatigue. He reports having felt fatigued and listless for about half a year, but he had attributed this to stress. He has lost considerable weight and, strangely, his skin looks tanned, even though he spends long hours at work and rarely ventures outside. His doctor finds very low blood pressure and a rapid, weak pulse. Blood tests show that Aaron does not have anemia, but his plasma glucose, cortisol, and Na⁺ are low, and his plasma K⁺ is high. His doctor orders an ACTH stimulation test, in which Aaron's secretion of cortisol is measured after he is given a synthetic form of ACTH.
(a) What would account for Aaron's low plasma Na⁺ and high plasma K⁺ ?
(b) What is the reason for doing an ACTH stimulation test?
(c) Which gland is primarily affected if ACTH does not cause a normal elevation of cortisol secretion? What is this abnormality called?
(d) Which gland is primarily affected if ACTH does cause an elevation of cortisol secretion?
