Endocrinology- Pituitary & Endo tumors

Question 1

Evaluation of acromegaly

Answer 1

Initial : insulin like growth factor1 (IGF1) level

Oral glucose suppression test (confirms acromegaly but not recommended as initial test)

Question 2

Mechanism of acromegaly

Answer 2

Pituitary somatotropin adenoma** –> ↑↑GH –> hepatic IGF1 secretion

**or extra pituitary GH/GHRH tumors

Question 3

Tx acromegaly

Answer 3

Transsphenoidal resection of the pituitary adenoma

Somatostatin analogues (octrotide)
Growth Hormone Receptor Antagonist (pegvisomant)

Question 4

Management of pituitary adenoma

Answer 4

Asymptomatic micro: no tx

Macro or symptomatic: dopaminergic agonists

Failed or very large: transsphenoidal resection

Question 5

Size classification of pituitary adenomas

Answer 5

Micro <10mm
Marco >10mm
Very large >3cm

Question 6

Dopaminergic agonists

Answer 6

Cabergoline

Bromocriptine