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Endocrine > Growth Hormone Problems > Flashcards

Growth Hormone Problems Flashcards

1
Q

What is the main cause of Gh Hypersecretion

A

Tumours

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2
Q

What is gigantism

A

A rare condition that causes abnormal growth in children

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3
Q

What parameter is most obviously increased in children with gigantism

A

Height (but girth also affected)

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4
Q

What causes gigantism

A

Pituitary tumours

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5
Q

What are rarer causes of gigantism

A

Mccune-Albright syndrome
Carney Complex
Multiple endocrine neoplasia (MEN1)
Neurofibromatosis

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6
Q

What is Mccune-Albright syndrome

A

Causes abnormal growth in bone tissue, patces of brown skin and gland abnormalities

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7
Q

What is Carney complex

A

An inheritied condition that causes non-cancerious tumours on connective tissue, cancerours or non cancerous endocrine tumours and spots on darker skin

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8
Q

What is MEN1

A

inherited disorder causing tumours of pituitary gland, pancreas or parathyroid gland

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9
Q

What is neurofibromatosis

A

An inherited disorder that causes tumours in the nervous system

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10
Q

What are symptoms of gigantism

A 
very large hands and feet
thick toes and fingers
Prominent jaw and forehead
Coarse facial features
excessive sweating
Insomnia 
Delayed puberty
irregular menstrual periods
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11
Q

How do you make the diagnosis of gigantism

A

Bloods (GH and IGF-1)

Oral glucose tolerance test

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12
Q

Why do a glucose tolerance test in gigantism

A

In acromegaly failure of suppression occurs, and there may be a paradoxical rise in GH in response to the glucose challenge.

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13
Q

What is treatment of gigantism

A

Surgical resection (transphenoidal)

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14
Q

What is acromegaly

A

The clinical manifestation of excessive growth hormone after epiphyeal plates have sealed. Long bones cant increase in height but they grow in other directions

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15
Q

What is the characteristic feature of acromegaly

A

Large hands and feet

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16
Q

What are the causes of acromegaly

A

Pituitary adenoma

Ectopic release of GHRH from a tumour elsewhere (bronchial carcinoid)

17
Q

What are symptoms of acromegaly (x9)

A 
Big features but same height 
Arthritis 
Organ dysfunction 
Headaches (if tumour) 
Bi-temporal heminaopea (if tumour)
Carpal tunnel syndrome
Lower voice pitch 
Macroglossia 
Sweating
18
Q

What effects of organ dysfunction can be seen in acromegaly

A

Hypertrophic heart
Hypertension
Type-2 Diabetes
Colorectal cancer

19
Q

What is treatment for acromegaly

A

Trans-sphenoidal surgery
Somatostatin analogues
Dopamine agonists
GH antagonists

20
Q

Name a somatostatin analogue

A

Ocreotide

21
Q

What do somatostatin analogues do?

A

They block GH release

22
Q

Name a dopamine agonist

A

Bromocriptine

23
Q

What do dopamine agonsit do

A

Block GH relase

24
Q

Name a GH antagonist

A

Pegvisomant

25
Q

What can cause hyposecretion of GH

A

A deficiency in GHRH
A deficiency in GH release from pituitary
Genetic mutations or underexpression of GH receptor
Precocious puberty
Hypothyroid dwarfism

26
Q

What is precocious puberty?

A

Excess GnRH stimulates puberty early causing kids to have stunted growth

27
Q

What are features of hypothyroid dwarfism

A

Children retain infantile features with stunted growth doe to loos of permissive effects of TH on GH.

28
Q

What is the screening test for Acromegaly

A

IGF-1 levels

29
Q

What is the diagnostic test for acromegaly

A

Oral glucose tolerance load test

30
Q

What investigations should you do for someone with suspected acromegaly

A 
Test IGF-1 levels 
Oral glucose tolerance load test 
Bloods (Glu, Calcium, Phosphate) 
Radiology
Visual field exam 
ECHO/ECG
31
Q

Why would you do an ECHO/ECG in acromegaly investigations

A

To assess for cardiovascular risk factors

Endocrine (14 decks)

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