A middle-aged female patient complains of changes to her face. Her cheekbones and eyebrows have become more prominent, and her jaw is growing. You suspect acromegaly, a disorder caused by excessive growth hormone. She had no growth abnormalities in her youth. What do you suspect is the most likely cause of her problem?

Question

A.  a tumour of the pineal gland
B.  congenital mutation of the GH regulatory region
C.  a tumour of the anterior pituitary
D.  a tumour of the posterior pituitary
E.  menopause

Clarify Question
What is the key concept addressed by the question?
What type of thinking is required?

Gather Content
What do you already know about growth hormone? What other information is related to the question?

Choose Answer
Given what you now know, what information is most likely to produce the correct answer?

Reflect on Process
Did your problem-solving process lead you to the correct answer? If not, where did the process break down or lead you astray? How can you revise your approach to produce a more desirable result?
 

Answer 1

C.  a tumour of the anterior pituitary

Clarify Question
What is the key concept addressed by the question?
        · What is the likely cause of acromegaly?
What type of thinking is required?
            o This is an evaluate question because you have to consider each potential cause of acromegaly and decide whether it would lead to increased growth hormone.

Gather Content
What do you already know about growth hormone? What other information is related to the question?
        · Growth hormone (GH) is produced by the anterior pituitary gland and regulates the growth of muscles, bones, and other tissues. The hypothalamus produces two hormones that regulate the production of GH- growth hormone-releasing hormone (GHRH) and growth hormone-inhibiting hormone (GHIH). As the names suggest, GHRH increases GH production and GHIH decreases it. Since the patient had no growth abnormalities in her youth, her problem is something that has changed recently.

Choose Answer
Given what you now know, what information is most likely to produce the correct answer?
        · While the patient is middle-aged and may be starting to experience menopause, hormonal shifts due to menopause do not significantly affect growth hormone or cause acromegaly. The pineal gland affects circadian rhythms in the body, not growth hormone. The anterior pituitary gland produces GH, not the posterior pituitary, so a tumor in the anterior pituitary gland could lead to an enlarged gland that produces more GH and lead to acromegaly. The patient was normal in her youth, which suggests that the problem is something recent, not a congenital mutation in the GH regulatory region that she was born with.

Reflect on Process
Did your problem-solving process lead you to the correct answer? If not, where did the process break down or lead you astray? How can you revise your approach to produce a more desirable result?
        Answering this question correctly depended upon evaluating each potential cause as to its appropriateness in finding the cause of increased growth hormone and thus acromegaly. If you got the answer correct, great! If not, which answer did you choose? Did you think that GH was produced in the posterior pituitary instead of the anterior pituitary? Did you think that because the woman is middle-aged that it had something to do with menopause?