Acromegaly

Question 1

Acromegaly is caused by a ____.

Answer 1

GH producing adenoma

Question 2

acromegaly is smilar to gigantism, except for?

Answer 2

happens after growth plates fuse- so in adults

Question 3

what is usually the initial screening test for acromegaly?

Answer 3

IGF-1

Question 4

MRIs will usually show what in acromegaly patients?

Answer 4

macroadenomas

Question 5

first line treatment for acromegaly

Answer 5

surgery, next’s medication therapy

Question 6

clinical features of acromegaly

Answer 6

• Metabolic: insulin resistance/ diabetes mellitus
• Skin: edema (lips, tongue, nose, hands, feet), acne/oily skin, sweating, skin tags
• Musculoskeletal: prognathism, frontal bossing, acral enlargement, widened teeth spacing/ jaw malocclusion, arthropathy, carpal tunnel
• Cardiovascular: hypertension, heart failure, sleep apnea
• Neuro: HA, fatigue
• Neoplastic: colon polyps, thyroid nodule

Question 7

Hallmarks of acromegaly

Answer 7

• Syndrome of progressive enlargement of the extremity, face, and organs
• GH secreting pituitary adenoma in > 90% of cases
• Elevated serum IGF-1 levels
• Multisystem complications

Question 8

epidemiology

Answer 8

3-4/million/ year

average age in 40s

Question 9

prognosis

Answer 9

morbidity is high

2-3x more than normal population