Agromegaly Flashcards
1
Q
What is the primary pathology in agromegaly?
A
-excess secretion/production of growth hormone
2
Q
What is the most common cause of excess growth hormone production?
A
- pituitary adenoma
- other causes are ectopic production from Ca (pancreatic)
3
Q
What are the clinical features of acromegaly?
A
- facial changes - protruding jaw, large tongue
- spade like hands
- oily sweaty skin
- mass effect - headaches, bitemporal hemianopia
- often raised prolactin - galactorrhoea
4
Q
What test is done to screen for acromegaly? expected results in disease state?
A
- serum IGF-1 levels
- increased in disease
5
Q
Once confirmed high IGF-1 levels, what is the confirmatory test for acromegaly?
A
- OGTT - 75g of glucose should suppress GH to less than 1ug
- GH isn’t suppressed in acromegaly
6
Q
What is the management of acromegaly?
A
- trans-sphenoidal surgical resection
- ocreotide - blocks GH production
- pegvisomant - GH receptor antagonist
