Question

Reduced EF in a pt with corse facial features and enlarged fingers.

Dx?
Acromegaly
Diagnostic steps?
check IGF-1 levels (high)
glucose suppression test
MRI
Tx options?
1st line treatment is surgery
prior to surgery you can give?
octreotide, or bromocriptine (DA agonist), or pegvisomant (GH receptor blocker)
most common cause of death?

Answer 1

Acromegaly, caused by excess growth hormone in adults, is diagnosed by checking IGF-1 levels, conducting a glucose suppression test, and using MRI. Surgical removal of the tumor is the primary treatment, with medications like octreotide, bromocriptine, and pegvisomant being used preoperatively.

Step-by-step explanation:

The diagnosis in a patient with reduced ejection fraction (EF), coarse facial features, and enlarged fingers is likely to be acromegaly, a condition caused by the overproduction of growth hormone (GH) in adults. To confirm the diagnosis, initial steps include checking the levels of insulin-like growth factor 1 (IGF-1), which are typically high in acromegaly. A glucose suppression test will demonstrate a lack of GH suppression, and an MRI of the brain can identify any adenohypophyseal tumors. For treatment, the first line is usually surgical removal of the adenoma if present. Medications like octreotide, a somatostatin analog, bromocriptine, a dopamine agonist, and pegvisomant, a GH receptor blocker, can be used to manage symptoms before surgery.