An investigator is studying a drug that acts on a G protein-coupled receptor in the pituitary gland. Binding of the drug to this receptor leads to increased production of inositol triphosphate (IP3) in the basophilic cells of the anterior pituitary. Administration of this drug every 90 minutes is most likely to be beneficial in the treatment of which of the following conditions?
AProstate cancer
BVariceal bleeding
CCentral diabetes insipidus
DAnovulatory infertility
EHyperkalemia
A 5-year-old boy is brought to the physician for excessive weight gain. The mother reports that her son has been “chubby” since he was a toddler and that he has gained 10 kg (22 lbs) over the last year. During this period, he fractured his left arm twice from falling on the playground. He had cryptorchidism requiring orchiopexy at age 2. He is able to follow 1-step instructions and uses 2-word sentences. He is at the 5th percentile for height and 95th percentile for weight. Vital signs are within normal limits. Physical examination shows central obesity. There is mild esotropia and coarse, dry skin. In addition to calorie restriction, which of the following is the most appropriate next step in management of this patient?
ALevothyroxine
BFluoxetine
CLaparoscopic gastric banding
DGrowth hormone therapy
EOctreotide
A 15-year-old girl comes to the physician with her father for evaluation of her tall stature. She is concerned because she is taller than all of her friends. Her birth weight and height were within normal limits. Her father is 174 cm (5 ft 7 in) tall; her mother is 162 cm (5 ft 3 in) tall. She is at the 98th percentile for height and 90th percentile for BMI. She has not had her menstrual period yet. Her mother has Graves disease. Vital signs are within normal limits. Examination shows a tall stature with broad hands and feet. There is frontal bossing and protrusion of the mandible. Finger perimetry is normal. The remainder of the examinations shows no abnormalities. Serum studies show a fasting serum glucose of 144 mg/dL. An x-ray of the left hand and wrist shows a bone age of 15 years. Which of the following is the most appropriate definitive treatment for this patient's condition?
ACaloric restriction
BLetrozole therapy
CMethimazole therapy
DTranssphenoidal adenomectomy
ELeuprolide therapy
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