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Endocrine > Acromegaly > Flashcards

Acromegaly Flashcards

1
Q

Acromegaly exam: general

A

Height

Large features

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2
Q

Acromegaly exam: hands

A 
BM pricks
Boggy/oily
Thick skin 
Spade-like
Median nerve: Thenar wasting, thumb abduction, sensation, tinels/phalens 
CTS release scars
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3
Q

Acromegaly exam: arms

A

BP

Proximal myopathy

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4
Q

Acromegaly exam: neck

A

Goitre

JVP

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5
Q

Acromegaly exam: face

A 
Prognathism
Large supraorbital ridge
Large ears, nose, lips
Teeth - spaced, underbite
Tongue - large = amyloidosis (ddx)

VISUAL FIELDS

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6
Q

Acromegaly exam: Legs

A

Proximal myopathy

Large feet

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7
Q

Concluding an acromegaly exam

A

Visual fields (if forgotten/no time in the exam)
Full CVS exam and ECG
Urine and BM - DM
Oral glucose tolerance test with serial GH measurements (glucose should suppress GH, if not = acromegaly)
IGF-1 levels
MRI pituitary

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8
Q

Management of acromegaly

A

Trans-sphenoid resection of the pituitary
If fertility is an issue use meds: octreotide - somatostatin analogy -> reduced GH
Address CVS RFs

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9
Q

Differentials for proximal myopathy

A

Endocrine:
Cushing’s
Acromegaly
Hyperthyroid

Neuro:
Myasthenia gravis
Muscular dystrophy

Rheum:
Poly/dermatomyositis

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Endocrine (4 decks)

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