Acromegaly + Hyperprolactinaemia Flashcards
what causes acromegaly
increased GH secretion from pituitary adenoma
what inhibits GH
Somatostatin
symptoms of acromegaly
increase in size of hands + feet coarsening of facial features - prominent supra-orbital ridge - prominent lower jaw - macroglossia (large tongue) headache sweating
investigation of acromegaly
initial screening test: IGF-1 levels
diagnostic: oral glucose tolerance test (OGTT)
how is an OGTT conducted
patient fasts from midnight
given 75mg of glucose
- normally GH is inhibited by increased glucose
- in acromegaly there is failure to suppress GH (GH will remain
OGTT result in acromegaly
GH will remain high - failure to suppress GH with glucose bolus
medical management of acromegaly
cabergoline (dopamine agonist)
octreotide (somatostatin)
surgical management of acromegaly
transphenoidal surgery +/- radiotherapy
apart from pituitary adenoma, what else can cause acromegaly
ectopic GHRH release from lung or pancreatic cancer
what visual field defect can large pituitary adenomas cause
bitemporal hemianopia
- loss of outer half of vision
excess GH can cause what conditions
HTN
Colorectal cancer
T2DM
Cardiac Hypertrophy
what are the physiological causes of high prolactin
pregnancy
breast feeding
what drugs can cause high prolactin
methyldopa
metoclopramide
haloperidol
oestrogen
symptoms of high prolactin in women
amenorrhoea
galactorrhea
symptoms of high prolactin in men
galactorrhea
infertility
loss of libido
impotence
