A 51-year-old woman comes to the physician because of fatigue and progressive pain and stiffness in her hands for the past 3 months. She used to play tennis but stopped 1 month ago because of difficulties holding the racket and her skin becoming "very sensitive to sunlight." Her last menstrual period was 1 year ago. She has diabetes mellitus controlled with insulin. She does not smoke or drink alcohol. Vital signs are within normal limits. Skin examination shows increased pigmentation over the knuckles and face. The liver is palpable 3-4 cm below the right costal margin. Which of the following is most likely contributing to the development of the patient's symptoms?

Question

A 51-year-old woman comes to the physician because of fatigue and progressive pain and stiffness in her hands for the past 3 months. She used to play tennis but stopped 1 month ago because of difficulties holding the racket and her skin becoming "very sensitive to sunlight." Her last menstrual period was 1 year ago. She has diabetes mellitus controlled with insulin. She does not smoke or drink alcohol. Vital signs are within normal limits. Skin examination shows increased pigmentation over the knuckles and face.  The liver is palpable 3-4 cm below the right costal margin.  Which of the following is most likely contributing to the development of the patient's symptoms?

Quizplus · Accepted Answer

Eductional Objective: Hereditary hemochromatosis can cause secondary hypogonadism due to deposition of iron in the pituitary gland, resulting in decreased gonadotropin secretion.  Patients who develop secondary hypogonadism are also at risk for deficiencies in other pituitary hormones (eg, central hypothyroidism).

A 51-Year-Old Woman Comes to the Physician Because of Fatigue