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Endocrinology > Growth Hormone disorder (Acromegaly) (Gigantism) (↓GH) > Flashcards

Growth Hormone disorder (Acromegaly) (Gigantism) (↓GH) Flashcards

1
Q

growth hormone normal functions?

-5

A

grows muscles & bones
stimulates IGF release
GH has glucose sparing effect
↑lipolysis

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2
Q

IGF effects?

-4

A

grows muscle + bones
protects bone
protects cartilage

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3
Q

which cells make growth hormone?

where are they located?

A

somatotrophs

Ant. pituitary gland

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4
Q

somatotrophs make up & wise how much on the endocrine cells in Ant. pituitary gland?

A

50%

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5
Q

problem with measuring growth hormone?

so what can you measure instead to give you a decent idea?

A

GH serum levels fluctuate a lot in the day

measure IGF

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6
Q

other name for growth hormone?

A

somatotropin

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7
Q

IGF released where?

A

liver

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8
Q

main cause for ↑GH in adult?

% wise how many times is this the cause?

A

Pituitary adenoma

95%

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9
Q

↑GH in adult called what?

A

Acromegaly

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10
Q

other causes of ↑GH (aside from Pituitary adenoma)?

-2

A

ectopic tumour

multiple endocrine neoplasia

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11
Q

ectopic tumour at which organ can commonly ↑GH levels?

A

pancreas

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12
Q

Acromegaly features around the face and mouth?

-3

A

Thick lips + tongue
Big gap between teeth
Protruding jaw

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13
Q

Thick tongue medical name?

A

macroglossia

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14
Q

Protruding jaw medical name?

A

prognathism

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15
Q

Acromegaly features/symptoms?

-7

A 
Big hands
Big feet
Thick lips + tongue – macroglossia 
Big gap between teeth
Protruding jaw – prognathism 
Sweaty skin
Oily skin
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16
Q

sign on eye examination?

why?

A

bitemporal hemianopia

pituitary adenoma hits on optic chiasm

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17
Q

what happens to blood glucose?

A

↑BG

18
Q

Suspect Acromegaly,

1st line Ix?

+ve result?

A

Serum Insulin growth factor (IGF-1)

↑↑

19
Q

Suspect Acromegaly.
Insulin growth factor (IGF-1) is up.

next Ix to confirm diagnosis?

A

Oral Glucose Tolerance Test

20
Q

Suspect Acromegaly.
Insulin growth factor (IGF-1) is up.
Oral Glucose Tolerance Test is abnormal.

next Ix?

why do you do this Ix?

A

MRI head

look for pituitary adenoma

21
Q

which blood test basically look at the all/most of the hormones that come from the pituitary?

A

Pituitary hormone screen

22
Q

in acromegaly, along with high GH, what other hormone can be high?

how often is it high in acromegaly pts %?

A

prolactin

20%

23
Q

main Ix to look for ectopic tumour causing acromegaly?

A

CT

24
Q

which blood test to check for high prolactin?

A

Pituitary hormone screen

25
Q

pt has confirmed acromegaly.

1st line Mx?

method used to get to the pituitary?

A

resect pituitary

trans sphenoidal - up nose

26
Q

pt has confirmed acromegaly.

what do you give to combat high prolactin?

A

give Dopamine

27
Q

pt has confirmed acromegaly.

surgery done, but still growth hormone is raised.

1st line drug to combat high GH?
-name

A

octreotide

28
Q

1st line drug to combat high GH?
-name

this drug is analogue of what hormone?

A

octreotide

somatostatin

29
Q

somatostatin effect on growth hormone?

A

suppression/inhibition

30
Q

2nd line drug to combat high GH?
- name

why is this drug used less than octreotide?

A

pegvisomant

expensive

31
Q

pegvisomant class?

A

GH receptor antagonist – blocks GH

32
Q

is surgery usually curative or not?

A

usually curative

33
Q

Prognosis for acromegaly?

A

decent - Life expectancy near normal once disease treated

34
Q

define gigantism?

A

high GH in a child

35
Q

usual cause of gigantism?

A

Pituitary adenoma

36
Q

extra features/ symptoms of gigantism not seen in acromegaly?

A

tall + delayed puberty

37
Q

why does gigantism cause increased height but acromegaly does not?

A

epiphyseal growth places not closed

38
Q

why is there delayed puberty in gigantism?

-step by step

A

↑GH in child > -ve feedback on HPA axis > less GnRH > hypogonadal > delayed puberty

39
Q

Growth Hormone Deficiency.

what happens to GH levels?

A

↓GH

40
Q

Diagnostic test for growth hormone deficiency?

result?

A

IGF blood test

low IGF

41
Q

1st line Mx for growth hormone deficiency?

A

give Synacthen (growth hormone)

Endocrinology (16 decks)

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