In high school, Jake had been a tall and well-coordinated student who was sought after by his school’s sports teams.

In high school, Jake had been a tall and well-coordinated student who was sought after by his school’s sports teams. He’d played on both the football and basketball teams. In his second year of college now, Jake came to the Student Clinic because of a sprained wrist. This gave the nurse an opportunity to do a complete history. In the course of the history, Jake mentioned that he felt clumsy compared to his high-school-athlete self. He was a large and slender young man, six feet four inches tall. He said probably his awkwardness was because he did not take any time for sports now, or even for physical activity beyond walking across campus, because college demanded so much study time and he also had a part-time job. Jake said he had not been especially tall in grade school. His growth spurt came in junior high. At one point, Jake scratched his head thoughtfully and said, “But you know, I think I’ve grown a lot since high school. And I’m still growing.” The nurse was about to say that people often do, when he began to suspect that Jake’s size might be due to an endocrine condition.

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1. What condition might Jake have? A. Gigantism B. Acromegaly C. Hypopituitarism D. Cushing’s syndrome

2. How would the diagnosis be confirmed?

3. How would you rule out the other options in #1?

4. What is Jake’s prognosis and treatment plan?