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Final Exam: Endocrine system case studies UNIT XI: Endocrine Function, Metabolism, and Nutrition Case Studies Case 1 B.J. is a 54-year-old attorney who for several months has been experiencing generalized headaches that have responded poorly to nonnarcotic analgesics. He is also experiencing visual disturbances including blurred vision and double vision. On questioning, B.J. reports that he has gained 20 pounds over 2 years despite no change in activity or eating patterns. About his weight gain, B.J. jokes, “I guess it’s all in my feet. I had to buy new shoes, and my shoe size went from a size 10 to a size 12.” It was determined that B.J. should have a CT scan of his head to assess for a pituitary adenoma resulting in the…show more content…
Without the presence of this hormone, this could be an indication the patient may have diabetes mellitus. Other signs may include dehydration (increase in water intake, thirsty). 4. B.J. receives subcutaneous 1-deamino-8-d-arginine vasopressin (ddAVP) to manage his high urine output. What is the rationale for this therapy? How can effectiveness be assessed? This form of therapy assists with eliminating water molecules within the urine by the binding of V2 receptors, increasing water reabsorption. This results for effectiveness can be determined by the current urine output, hopefully decreasing. 5. It is expected that after his transsphenoidal hypophysectomy, all of B.J.’s anterior pituitary hormones will be deficient (panhypopituitarism). What type of hormone replacement will be needed? With the removal of the pituitary gland, this has abruptly stopped a hormone output completely. B.J. will most likely have to have a life-long treatment plan to produce the hormones needed to regulate bodily organs and functions. Testosterone will be taken for male hypogonadism, hydrocortisone for adrenal insufficiency, levothyroxine for hypothyroidism, growth hormones, and desmopressin to replace the anti-diuretic hormone. 6. What information should be given to B.J. about the expected duration of hormone therapy and monitoring of treatment efficacy? Aside from having a life-term hormone therapy treatment,
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