Whats My Disorder?

Endocrine Case Studies

by Gabriele Aborn, Chattanooga, TN

Name:____________________________
Date:_____________________________

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Patient: Allen Adams

Allen Adams, a 34 year old computer technician, has recently recovered from a bicycle accident
where he lost control and hit his head on the sidewalk. Unfortunately, he was not wearing his helmet.
For awhile, everything seemed alright. Then Allen started to develop some unusual symptoms.
When asked about his symptoms at the doctors office, Allen states Im thirsty and drink water all
the time. And whats worse, it seems to go right thru me straight to my bladder! He pulls out
some lip balm for his cracked lips and continues, You have to do something. Im practically living
in the bathroom! You ask several more questions and then order a CT scan, a urinalysis, and a
blood test.
The CT scan shows an injury at the arrow.

pituaritary gland
1. What is the name of this gland? ___________________________
2. Identify and describe the 2 hormones stored in the posterior portion of this gland?
Oxytosin and ADH.
Oxytocin stimulates uterine contractions and release of milk from the
_________________________________________________________________________

breast. ADH absorbs Water form the kidneys when needed.

_________________________________________________________________________

The hypothalamus
3. What structure actually produced these 2 hormones? _______________________________
Posterior pitituary
4. What structure controls the release of these 2 hormones? ___________________________
5. How does the structure (from question 4) control the release of these 2 hormones?

realeases the hormone.

If there is a stimulus, the posterior pit uary

_________________________________________________________________________
Look at the test results for the blood and urinalysis.

The sodium and the osmolality is high

6. What is abnormal about Allens blood? __________________________________________
Not enough water in his system
7. What does this mean? (Hint: remember Allens cracked lips) _________________________
8. What is abnormal about Allens urine? __________________________________________
___________________________________________________________________________
9. Based on the blood and urine lab results, which of the 2 hormones you listed on question 2 is the
problem in this patient? ____________________________________________________
10. Which organ(s) does this hormone target? _________________________________________
11. Is the problem hyposecretion or hypersecretion of this hormone? _______________________
12. What is the name of this disorder? _______________________________________________

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Patient: Bob Barten

Bob Barten was not aware something was wrong for a long time. His friends, co-workers, and even
his wife never noticed anything. Bob just gradually became aware that his shoes were
uncomfortable. He finally had to go and buy a new pair in a larger size. Then one Saturday the work
gloves he used for his sporadic gardening didnt fit anymore. Jill? Did you wash my gloves?
Theyve shrunk! Jill rolls her eyes and replies, Not hardly Maybe your hands are swollen for
some reason. I think we better call for a doctor and check you out. Dr. Phillips, their family doctor
for many years, did notice a change. Tell me, Bob. Other than changes your hands and feet, have
you noticed anything else? Well, I dont feel much like doing much of anything anymore, but
even though Im just sitting around, I seem to sweat a lot. I just dont feel as strong as I used to
either. Dr. Phillips then tells you to take Mr. Barten and get X-rays, blood test, and basic urinalysis.
The X-ray shows a benign tumor in the circle.

pituitary gland
1. What is the name of this gland? ___________________________
2. List the 6 hormones produced in the anterior portion of this gland:
LH, FSH, Prolactin, ACTH,TSH,hGH
_________________________________________________________________________
3. The release of these hormones is controlled by which structure?
tHE Hypotalamus
________________________
4. How does this structure control the release of these hormones?
When your body needs a hormone , the hypothalamus releases a releasing factor hormone. That
_________________________________________________________________________

sitmulates the pituitary.

5. Four of the six hormones from question 4 are tropic hormones. What is a tropic
hormone?
ADH, LH,ACTH,TSH
_________________________________________________________________________
6. List the four tropic hormones and the target of that hormone.

ADH
___________________
___________________
LH
ACTH
___________________
TSH
___________________

Promotes the retension of water by the kidney

__________________________________________
stimulates sex hormone rpoduction in ovaries and texes
__________________________________________
__________________________________________
stimulates the adrenal cortex to secrete gluccoticoids
stimulates the thyroid gland
__________________________________________

Look at the test results for the blood and urinalysis.

7. Is there anything abnormal in Mr. Bartens blood lab results? _________ If so what?
_______________________________________________________________________
8. Is there anything abnormal in Mr. Bartens urinalysis? ___________ If so what?
_______________________________________________________________________

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There is a before and after photo of a woman that has the same disorder as Bob Barten. In
addition, there is a photo of a man with this disorder.
9. What differences can you see between the before and after photos of the woman? Are there any
other irregularities?_____________________________________________________________
____________________________________________________________________________
__________________________________________________________________________
10. Describe the facial features of the man.
___________________________________________________________________________
___________________________________________________________________________
11. Based on the information presented in this case study, which hormone is the problem in Bob?
_______________________________________________________
12. Is the problem hyposecretion or hypersecretion of this hormone? _______________________
13. What is the name of this disorder? _____________________________
14. Suppose Bob was not an adult and was only eight years old.
called? _________________________

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What would this disorder be

Patient: Carrie Carson

Carrie Carson is a 52-year-old, overweight house-wife. She has come in complaining about a sore
on the side of her big toe. It just doesnt want to heal no matter what I do, she explains. When
you ask about how she feels in general, she replies Im tired and I dont feel as strong as I used to
be. Im also hungry and thirsty all the time. You ask several more questions and then order a
CT scan, a urinalysis, and a blood test.
1. What is the name of the green gland? ______________________________
2. This gland produces 2 hormones. List them. ______________________________________
Look at the test results for the blood and urinalysis.
3. Is there anything abnormal in Carries blood results? ________ If so, what?
_______________________________________________________________________
4. Is there anything abnormal in Carries urinalysis? __________ If so, what?
_______________________________________________________________________
5. You have written down in your case notes that Carrie exhibits 3 symptoms: polyuria, polydipsia,
and polyphagia. Give the definition of each:
Polyuria: __________________________________________________________________
Polydipsia: _________________________________________________________________
Polyphagia: _________________________________________________________________
There are photos of patients that have severe complications of the disorder Mrs. Carson
has.
6. What factors could have lead to these ulcerations? __________________________________
7. Based on the information presented in this case study, which hormone is the problem in Carrie?
8. Is the problem hyposecretion or hypersecretion of this hormone? (Note that Carrie has had this
problem for quite some time.) ________________________________________
9. What is the name of this disorder? ______________________________________
10. In the earlier stages Carrie may have shown hypersecretion of this hormone. Explain this
apparent contradiction: ___________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

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Patient: Donna Daniels

Donna Daniels was always an avid tennis player; she was fit, deeply tan, and full of energy. Lately,
however, she has started to lose weight and feel weak. When you ask for more specifics, she
replies, I have no appetite lately except for salty foods. My stomach hurts and I feel nauseous most
of the time. And in the last week or so, Ive been getting dizzy. While taking Ms. Daniels vital
signs, you notice that her blood pressure is very low and her pulse is rapid and weak. Her hands
show unusually heavy pigmentation on her knuckles. While Ms. Daniels is talking, you notice that
her gums also show spots of pigmentation although they appear healthy. You order a CT scan,
blood test and urinalysis.
1. What are the names of the glands that the lines are pointing to?

_________________________

2. What organs are found below these glands? ________________________

3. This gland has an inner layer and an outer layer. The inner layer is called the _____________.
Give the 2 hormones secreted by the inner layer:

_______________________

__________________________

4. What controls the release of these 2 hormones: _____________________________________

5. What are the affects of these hormones on the body? __________________________________
____________________________________________________________________________
____________________________________________________________________________
6. The outer layer of this gland is called the _______________.
produces and the function of each:

Give the 2 groups of hormones it

______________________________

______________________________________

______________________________

______________________________________

7. Many of these hormones from the outer layer are released due to stimulation from which pituitary
hormone? _______________
Look at the test results for the blood and urinalysis.
8. Is there anything abnormal in Ms. Daniels blood results? _________ If so, what?
____________________________________________________________________________
9. Is there anything abnormal in Ms. Daniels urinalysis? _________ If so, what?
_____________________________________________________________________________

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There are photos of a patients mouth and hand who exhibits the same symptoms as Donna
Daniels.
10. What pigment is being overproduced in Donnas skin and gums? _______________________
11. Based on the information presented in this case study, which hormones are producing the
problem in Donna Daniels? ______________________ and __________________________
12. Is the problem hyposecretion or hypersecretion of these hormones? _____________________
13. What is the name of this disorder? ________________________________________
14. Describe other symptoms of this disorder. _________________________________________
___________________________________________________________________________
___________________________________________________________________________

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Patient: Ellen Evergreen

Ellen Evergreen has come in to the doctors office because of her insomnia. Im having such a
problem sleeping. And since Im not sleeping right, Im tired all the time and I get these terrible
mood swings. The only good thing is that I seem to be losing weight. You notice as you take
Ellens vitals that her face is flushed and moist with perspiration. You write down that both her
blood pressure and heart rate are high. You ask several more questions and then order a CT scan, a
urinalysis, and a blood test.
The image shows a gland labeled 1.
1. What is the name of this gland? _______________________________
2. What hormone from the anterior pituitary gland stimulates this gland? _____________
3. Identify the 2 main hormones produced from the gland and describe their functions.
______________________________________________________________________
______________________________________________________________________
Look at the test results for the blood and urinalysis.
4. Is there anything abnormal in Ellens blood results? _________ If so, what? ____________
_________________________________________________________________________
5. Is there anything abnormal in Ellens urinalysis?

_________ If so, what? _______________

____________________________________________________________________________
There is a photo of a patient that has the same disorder as Ellen Evergreen.
6. Protrusion of the eyes is sometimes a sign of this disorder. What is the medical term for the
protrusion of the eyes? _______________________________________________________
7. Based on the information presented in this case study, which hormone(s) is the problem in Ellen?
_____________________
8. Is the problem hyposecretion or hypersecretion of this hormone?
__________________________
9. What is the name of this disorder?
___________________________________________________
10. Describe some symptoms of this disorder. ____________________________________________
______________________________________________________________________________

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11. Ellen Evergreen undergoes a surgical procedure to remove the entire gland. Unfortunately, this
removes four other small glands embedded on the posterior surface. What is the name of these
four glands? __________________________________________
12. What is the name of the hormone these small glands secrete? ____________________________
13. The function of this hormone is to increase levels of __________________

in the blood.

14. Without this hormone, what specific symptoms will Ellen start to show? _____________
_______________________________________________________________________

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Patient: Fiona Franklin

Fiona Franklin, a 42 year old secretary, has finally set up an appointment with her doctor at the
urging of her best friend. You notice that Fiona is overweight with dry, brittle hair and that her neck
appears to be somewhat swollen. She is dressed in a long sleeved sweater, which is a little
surprising considering the warm weather lately. When you ask for some details about how she feels,
Fiona replies very slowly and deliberately as if she is having difficulty finding the right words.
Im so tired lately and I cant hardly take working in the office anymore its just so cold. And I
think I need to see a dermatologist Ive tried everything but my skin is so dry and rough.
You
set up several tests including a blood test and a urinalysis.
1. This is the gland that showed an enlargement in Fiona. What is the name of this gland (red
arrow)? __________________________________________________
2. What hormone from the anterior pituitary gland stimulates this gland? ____________
3. The gland (at the arrow) produces 2 hormones. List them.
_____________________________________________________________________________
There are photos of other patients with this enlarged gland.
4. What is the common name for this enlargement? ___________________________________
Look at the test results for the blood and urinalysis.
5. Is there anything abnormal in Fionas blood results? _________ If so, what?
________________
______________________________________________________________________________
6. Is there anything abnormal in Fionas urinalysis? __________ If so, what?
_________________
______________________________________________________________________________
7. Based on the information presented in this case study, which gland is the problem in Fiona?
_____________________________________________________________________________
8. If the blood results showed below normal levels of both T4 and TSH, which gland would be the
problem (this is NOT Fionas situation)?_____________________________________________
9. Is Fionas problem hyposecretion or hypersecretion of the involved hormone? _______________
10. Since Fiona is an adult, what is the name of this disorder? _______________________________
11. Identify some other symptoms of this disorder ________________________________________
12. If Fiona developed this disorder in infancy, what medical term would be used?
_______________

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