Acromegaly

Question 1

How to test for acromegaly and what test is done next to confirm that?

Answer 1

First insulin growth factor-1 is done then growth hormone suppression test to confirm it

Question 2

What’s the best treatment for pituitary adenoma?

Answer 2

Transphinoidal surgical resection is the best for microadenoma <10mm or macroadenomas that is well-circumscribed or not involving the cavernous sinus, but in case of cavernus sinus is invaded by the adenoma then medical management is done to shrinks the adenoma first

Question 3

What is the first line medical treatment for pituitary adenoma?

Answer 3

Is somatostatin analogues as octeriotide. While cabergoline is the second line of treatment

Question 4

In case the ptn is partially responding to treatment with octeriotide, what’s the best drug to add?

Answer 4

Pegvisomant ( GH receptor antagonist )

Question 5

What’s the most common location of excessive GH secretion?

Answer 5

Anterior pituitary

Question 6

On what conditions the glucose administration for GH suppression test may not work?

Answer 6

DM, certain hepatic and renal disease, anorexia nervosa, pregnancy, puberty

Question 7

Pituitary adenoma must be removed in case of optic chiasm compression even if it’s macroadenom, true or false

Answer 7

True