endo acromegaly

Question 1

etiology of acromegaly

Answer 1

mostly pituitary adenoma

ectopic secretion of crowth hormones from small cell lung cancer pancreatic islet cell tumor (ass with MEN 1)

hypothalmic tumor causing incr ghrh

Question 2

clinical features of acromegaly

Answer 2

features of mass effect , bitemporal hemianopia, headache
oligomenorrhea, galactorrhea, secondary amenorhea
erectile dysfunction, decr libido

enlarged nose forehead jaw
painful arthopathy

gigantism in children

Question 3

what is the best single test to test for acromegaly

Answer 3

igf-1-if elevated then sus acromegaly and do ogtt

if normal then its ruled out

Question 4

what is the best test to confirm acromegaly

Answer 4

ogtt with baseline gh measurement..then measure after 2 hours

normally with meal gh level is decreased but it wont be decreased in acromegally as there is an ectopic source of gh production

Question 5

what is the imaging modality of choice for acromegaly

Answer 5

mri pituitary

Question 6

surgical procedure of choice for acromegaly

Answer 6

transphenoidal adenmectomy

Question 7

medical treatment for acromegaly

Answer 7

somatostatin analogue( inhibit growth hormone): octreotide

dopamine agonist:carbergoline reduce tumor size and gh secretion

gh receptor antagonist: pegvisomant