BOF: 2.19
A 17-year-old boy presents complaining that he has not
begun to shave unlike his friends. There is no previous medical history of
note nor is there a significant family history. On examination he is tall. The
upper segment of his body is longer than the lower segment. His arm span is
more than 5 cms longer than his height in metres. There is no hair on his
beard and moustache area and there is no hair over his body. Pubic and
axillary hair is not present. His penis is small and the testes are small as
well. Apart from anosmia no other abnormalities can be detected on examination
of his other systems.
In this patient, which of the following features suggests
that he has hypogonadotrophic hypogonadism?
a)
Eunuchoidal proportions
b)
Small penis
c)
Small testes
d)
Absence of facial and body hair
e)
Anosmia
Answer:
e)
The patient has features of hypogonadism. Eunuchoidal
proportions (lower segment longer than upper segment, arm span more than 5 cms
greater than height) small genitalia; decreased body and facial hair all
suggest hypogonadism. Anosmia would suggest that this is due to Kallman’s
syndrome
or hypogonadotrophic hypogonadism.
Idiopathic hypogonadotrophic hypogonadism
