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Endocrine Case Studies
Case 1: Diabetes Mellitus (Type 1)
Patient:
Mr. Ananda, 45, exhausted, weight loss, unconscious.
Symptoms:
Severe fatigue, unexplained weight loss, polydipsia, polyuria, "fruity" breath.
Lab Results:
High plasma glucose, low serum bicarbonate, very low C-peptide.
Cause:
Lack of insulin from pancreatic β-cells.
Diagnosis:
Type 1 Diabetes Mellitus with DKA.
Case 2: Acromegaly
Patient:
Mrs. Gita, 50, enlarging hands/feet, prominent jaw, headaches.
Symptoms:
Enlarging hands and feet, coarsening facial features, headaches.
Lab Results:
High IGF-1, GH not suppressed by glucose.
Cause:
Excess Growth Hormone (GH) from a pituitary tumor.
Diagnosis:
Acromegaly.
Case 3: Hypothyroidism (Hashimoto's)
Patient:
Mrs. Devi, 40, fatigue, weight gain, cold intolerance.
Symptoms:
Fatigue, weight gain, cold intolerance, dry skin, constipation.
Lab Results:
High TSH, low Free T4, positive Anti-TPO Antibodies.
Cause:
Low thyroid hormone (T4) due to autoimmune destruction of thyroid gland.
Diagnosis:
Primary Hypothyroidism (Hashimoto's Disease).
Case 4: Hyperthyroidism (Graves' Disease)
Patient:
Mr. Raj, 35, hand tremor, weight loss, heat intolerance, rapid heartbeat.
Symptoms:
Hand tremors, weight loss, heat intolerance, rapid heartbeat, bulging eyes.
Lab Results:
Low TSH, high Free T4, positive Thyroid Stimulating Immunoglobulin (TSI).
Cause:
Autoantibodies mimicking TSH, leading to excess thyroid hormone.
Diagnosis:
Hyperthyroidism (Graves' Disease).
Case 5: Cushing's Syndrome
Patient:
Ms. Priya, 55, central obesity, thin limbs, "moon face."
Symptoms:
Central obesity, thin limbs, "moon face," "buffalo hump," high blood pressure, easy bruising.
Lab Results:
High 24-hr urine cortisol, low plasma ACTH.
Cause:
Excess cortisol from an adrenal tumor.
Diagnosis:
Cushing's Syndrome.
Case 6: Addison's Disease
Patient:
Mr. Singh, politician, severe weakness, low blood pressure, hyperpigmentation.
Symptoms:
Severe fatigue, low blood pressure, salt cravings, hyperpigmentation.
Lab Results:
Low morning cortisol, high plasma ACTH, low serum sodium, high serum potassium.
Cause:
Adrenal gland failure (lack of cortisol and aldosterone).
Diagnosis:
Primary Adrenal Insufficiency (Addison's Disease).
Case 7: Hyperparathyroidism
Patient:
Mrs. Lakshmi, 65, easy bone fractures, achy, constipated.
Symptoms:
Bone pain/fractures, kidney stones, abdominal pain, depression.
Lab Results:
High serum calcium, high PTH (despite high calcium).
Cause:
Excess Parathyroid Hormone (PTH) from a parathyroid tumor.
Diagnosis:
Primary Hyperparathyroidism.
Case 8: Kallmann Syndrome
Patient:
Leo, 19, absent puberty, inability to smell.
Symptoms:
Absent puberty, anosmia (inability to smell).
Lab Results:
Very low testosterone, very low LH/FSH.
Cause:
Failure of GnRH neurons to migrate to the hypothalamus during fetal development.
Diagnosis:
Kallmann Syndrome.
Hypothalamic Hormones
TRH (Thyrotropin-Releasing Hormone):
Stimulates TSH release.
CRH (Corticotropin-Releasing Hormone):
Stimulates ACTH release.
GnRH (Gonadotropin-Releasing Hormone):
Stimulates LH and FSH release.
GHRH (Growth Hormone-Releasing Hormone):
Stimulates GH release.
Somatostatin (GHIH):
Inhibits GH release.
Dopamine (PIH):
Inhibits Prolactin release.