Presentation Symptoms depend on specific hormone deficiency ↓ FSH/LH impotence (males), amenorrhea (females) late-onset puberty (children) ↓ GH growth delay (children) muscle wasting (adults) hypoglycemia (adults) GH normally gluconeogenic ↓ TSH weakness constipation cold intolerance Evaluation FSH/LH GnRH stimulation test no change in FSH/LH release in hypopituitarism see ↑ in cases of hypothalamic causes GH Arginine and sleep stimulation tests no change in GH release in hypopituitarism GH normally released at maximum rate at 5 AM TSH TRF stimulation no change in TSH release in hypopituitarism ACTH metyrapone test inhibitor of adrenal 11-hydroxylase normally results in ↓ conversion of 11-deoxycortisol to cortisol consequent ↑ in ACTH release and ↑ in 11-deoxycortisol proximal to the inhibited enzymes in cases of hypopituitarism there is no ↑ in ACTH or 11-deoxycortisol in adrenal disease there is an ↑ in ACTH but not 11-deoxycortisol
QUESTIONS 1 of 1 1 Previous Next (M1.EC.14.6) A 16-year-old girl presents with fatigue and reports missing her period for the past several months though her prior menses were regular. She is short for her age. Her mother has been worried since her daughter started bumping into the furniture around the house. You perform a visual field in the office which reveals the following (Figure A). Vital signs are stable with the exception of blood pressure which is slightly lower than her baseline. The remainder of her physical examination is unremarkable. Regarding this patient, one would also expect to find: QID: 104331 FIGURES: A Type & Select Correct Answer 1 Hyperkalemia 9% (5/55) 2 Hyperpigmentation 16% (9/55) 3 Salt wasting 16% (9/55) 4 Elevated plasma cortisol level 13% (7/55) 5 Hypoglycemia 45% (25/55) M 2 Question Complexity E Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 5 Review Tested Concept Review Full Topic