Others

Question 1

Acromegaly

• Cause?
• Symptoms?

Answer 1

• Excessive growth hormone, usually due to a pituitary adenoma
• Coarse facial features, spade like hands, large feet, large tongue, protruding jaw- proganthism, sweat, oily skin, galactorrhoea due to raised prolactin.

Question 2

Acromegaly

• Tests
• Treatment
• Complications

Answer 2

• Serum IGF1 as GH levels vary throughout the day, pituitary MRI
• Transphenoidal surgery, somatostatin analogue, octreotide.
• Hypertension, diabetes, colorectal cancer.

Question 3

Primary hyperaldosteronism/ Conn’s syndrome

Answer 3

Excess in aldosterone.
Conn’s syndrome is due to an adrenal adenoma.
Other causes: bilateral adrenal hyperplasia, adrenal carcinoma.

Question 4

Symptoms of primary hyperaldosteronism

Answer 4

Sodium and water retention- - hypertension, hypokalaemia and muscle weakness, alkalosis.

Question 5

Primary hyperaldosteronism- tests and treatment

Answer 5

Plasma aldosterone:renin ratio
High resolution CT abdo

Surgery
Aldosterone antagonist- spironolactone.

Question 6

Phaeochromocytoma- cause, symptoms, treatment

Answer 6

Rare catecholamine secreting tumour.
Familial in 10%, bilateral in 10%, malignant in 10%
Associated with various syndromes.

Symptoms: headaches, hypertension, palpitations, sweating, anxiety.
Do 24 hour urinary metanephrines.

Surgery, first stabilise them with an alpha blocker e.g. phenoxybenzamine and then a beta blocker e.g. propranolol.