acromegaly

Question 1

what is acromegaly

Answer 1

clinical manifestation of excessive growth hormone

Question 2

most common cause of unregulated GH secretion

Answer 2

pituitary adenoma

Question 3

what can happen with pituitary tumour of good size if presses on optic chiasm

Answer 3

bitemporal hemianopia

Question 4

features: tissue overgrowth

Answer 4

prominent forehead + brow 
large nose
large tongue 
large hands and feet
large protruding jaw
arthritis

Question 5

features: organ dysfunction

Answer 5

hypertrophic heart
htn
T2DM
colorectal cancer

Question 6

symptoms suggesting active raised GH

Answer 6

developing new skin tags

profuse sweating

Question 7

initial screening test

Answer 7

insulin-like growth factor (IGF-1)

Question 8

Ix

Answer 8

IGF-1
OGTT whilst measuing GH (glc normally supresses GH)
MRI

Question 9

Mx - if 2ry to pituitary adenoma

Answer 9

trans-sphenoidal removal of tumour

Question 10

Mx - 2ry to lung or pancreatic ectopic secretion

Answer 10

surgical cancer removal

Question 11

medications that can be used to block GH

Answer 11

pegvisomant
somatostatin analogues
dopamine agonists

Question 12

somatostatin

Answer 12

growth hormone inhibiting hormone