Acromegaly Flashcards
1
Q
- Hands (3)
A
- Wide, ‘spade-like’ hands
- Thick, stubby fingers
- Fist sign
2
Q
- Face (6)
A
- Increased frontal bossing
- Wide nose
- Thick nasolabial folds
- Jaw growth
- Widely spaced teeth
- Macroglossia
3
Q
General (11)
A
- Acanthosis nigricans
- Skin tags
- Tall (rare)
- Large feet
- Very deep voice
- Sweaty, warm, oily skin
- CTS
- HTN
- Bitemporal haemianopia
- Goitre - due to increased vascularity
- Heart failure
4
Q
Investigations
A
- IGF-1 and GH
- OGTT - failure to suppress GH secretion
- MRI brain
Bonus: HbA1c, Glucose, TTE
5
Q
Tests for pituitary function (5)
A
- 9am cortisol
- Testosterone or oestradiol
- LH, FSH
- Prolactin
- TSH + T4
6
Q
Cx of Acromegaly (17)
A
- CCF
- CTS
- DM
- OA
- HTN
- Galactorrhoea
- Enlarged jaw
- PN
- Macroglossia
- Skin tags
- Colonic polyps
- OSA
- Visual defect
- Goitre
- Headache
- Hypopit
- Erectile dysfunction
7
Q
Diabetes treatment goal
A
- regulate diet, exercise and insulin so as to allow the patient to lead a normal life while avoiding short and long term complications
8
Q
Causes of hypo’s (4)
A
- decreased food intake, increased exercise/LOW
- injection error
- diabetic renal disease
- rare: insulin abs, mal-abs, hypothyroidism
9
Q
DNE (4)
A
- Educate: purpose of Rx
- Diet, wt, exercise program
- Adherence - SE’s
- Exclude infection, new meds e.g., steroids
