Endocrine Flashcards
what is acromegaly
excess growth hormone secondary to a pituitary adenoma
what are the features of acromegaly
coarse facial appearance
large tongue
excessive sweating , oily skin
bitemporal hemianopia
raised prolactin
complications of Acromegaly
- htn
- diabetes
- cardiomyopathy
- colorectal cancer
1st line investigation for acromegaly
Serum IGF -1
OGTT is used to confirm the diagnosis if IGF-1 levels are raised
first line treatment for acromegaly
trans- sphenoidal surgery
if a pituitary tumor is inoperable or surgery unsuccessful then what medication may be used
- somatostatin analogue
- pegvisomant
- dopamine agnosts
what do somatostatin analogies do
inhibit the release of growth hormone-
what does pegvisomant do
GH receptor antagonist - prevents dimerisation of GH receptor
What is cushings syndrome
The clinical manifestation of pathological hypercorticolism from any cause
what is the most common cause of cushings syndrome
exogenous corticosteroid exposure
what is cushings disease
hypercortisolism caused by an adrenocorticotrophic hormone ACTH pituitary adenoma
what is pseudocusings usually due to
-due to alcohol excess or -severe depression
causes false positive dexamethasone suppression or 24hr urinary free cortisol
what are the risk factors for cushings
- female
- hypertension
- glucose intolerance
- premature osteoporosis
first line for cushings
overnight low dose dexamethasone suppression test
- 24hr urinary free cortisol ; 2 x readings needed
- bedtime salivary cortisol
