HLSC 3P09 Lecture Notes - Lecture 9: Acromegaly, Erectile Dysfunction, Hormone Replacement Therapy

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A 48-year-old man complaining of impotence sought medical attention. Over the years, he experienced increasing difficulty with maintaining and, more recently, achieving an erection. Further questioning revealed that he was also shaving less frequently. The patient"s shoe size had increased from a 9-c to 11-eee over the past 5 years, and his dental plate had to be altered three times in 6 years. Recently, friends have remarked on changes in his appearance. The patient also admitted to tingling of his fingers and joint pains. On physical examination, he had coarse facial features with a bulbous nose and beetle-browed look. The tongue was enlarged and teeth were wide spaced. Testing of visual fields showed a loss of both lateral (temporal) fields. The hands and feet were enlarged with spadelike fingers. Laboratory studies showed a fasting plasma glucose level of 150 mg/dl. Fasting growth hormone (gh) was 40 ng/ml, and it did not decrease after administration of an oral glucose load.

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