HPA axis 2

Question 1

diagnosis of hyper-pituitary acromegaly

Answer 1

increased serum somatotropin (growth hormone)

-MRI, X-rays, physical exam, oral glucose challenge test (level does not decrease)

Question 2

complications of hyper-pituitary acromegaly

Answer 2

increased ICP and enlarged tumour

increased blood sugar

Question 3

clinical manifestations of hyper-pituitary acromegaly

Answer 3

• enlarged pituitary gland
• headache
• visual disturbances
• menstrual changes
  etc

Question 4

treatment for precocious puberty

Answer 4

GnRH analogue

• causes an overstimulation of the system and hormonal levels drop

Question 5

kallmann syndrome

Answer 5

GnRH deficiency
- usually due to a mutation

-will present with olfactory symptoms as this is where GnRH originates

Tx should start early: induction of puberty is critical for sexual, bone, metabolic and psychological health
GnRH therapy to enable fertility and oestrogen-progestin therapy

Question 6

GnRH-dependent precocious puberty

Answer 6

high LH and FSH
and high estradiol levels

early activation of HPG axis and relatively blunted ovarian function

may have 47 XXX karotype