acromegaly

Question 1

caused by over production of?

Answer 1

growth hormone

Question 2

what are majority of cases caused by?

Answer 2

GH secreting primary tumours

Question 3

these tumours may develop as part of

Answer 3

MEN-1

Question 4

what pituitary symptoms do you get?

Answer 4

hypopituitirism or tumour symptoms (BTH)

Question 5

complications ?

Answer 5

diabetes
malignancy of bowel
cardiovascular - increased risk of IHD

Question 6

what is growth hormone also known as?

Answer 6

somatotrophin

Question 7

what bloods would you do?

Answer 7

glucose, calcium, PO4, high GH?IGF1 levels

Question 8

what is the first line treatment ?

Answer 8

surgical excision of pituitary tumour

Question 9

second line? pharmacological ?

Answer 9

if surgery not possible or fails to correct growth hormone level 
somatostain analogues 
sandostatin 
ocreotide 
(sandiford in october)

Question 10

what do sandostatin and ocreotide do to headache?

Answer 10

relieve almost immediately

Question 11

are these drugs able to shrink the tumour?

Answer 11

yes

Question 12

side effects of ocreotide and sandostatin?

Answer 12

GG
GI side effects
Gallstones

Question 13

what is cabergoline

Answer 13

dopamine agonist

Question 14

what does cabergoline do to GH secretion?

Answer 14

reduces it - THIS IS NOT CURATIVE

Question 15

what blocks the peripheral action of GH but does not shrink the tumour?

Answer 15

GH antagonist (pegvisomant)