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5 Cards in this Set

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  • Back
What are the laboratory features of acromegaly?
E: Diagnostic lab abnormalities include elevated GH with failure to suppress with oral glucose administration and an elevated IGF-1 (somatomedin-C).
A: IGF-1, suppress.*GH
What is the treatment of choice of acromegaly?
E:Transsphenoidal surgical resection is typically the treatment of choice.
What drugs are useful in the treatment of acromegaly?
E:Medical treatment is often required because many tumors are too large at presentation to be completely excised by surgery. In such cases, somatostatin analogs are indicated for medical therapy to control GH secretion. GH cells have somatostatin receptors and treatment with somatostatin analogs (octreotide), have been shown to decrease GH levels and induce tumor shrinkage. A new GH receptor antagonist, pegvisomant, has also been approved for medical therapy. Although less effective, dopamine agonists such as bromocriptine or cabergoline can also be tried to control GH levels. Finally, radiation therapy can be offered to patients who fail surgical and medical interventions.
A: pegvisomant, cabergoline, bromocriptine, octreotide
Name three agents useful for the treatment of prolactinomas.
E:Dopamine agonists have been shown to inhibit prolactin secretion and cause tumor shrinkage. Examples include bromocriptine, pergolide, and the newer, more potent agent, cabergoline. All must be started at low doses and titrated upward very slowly to avoid side effects. The most common side effects include nausea, vomiting, and orthostatic hypotension. Cabergoline appears to be the best tolerated but most expensive option.
A: cabergoline, bromocriptine, pergolide
What is the "stalk effect"?
E:Large non-prolactin-secreting tumors compress the pituitary stalk, thus interrupting the tonic inhibitory effect of dopamine (or prolactin-inhibiting factor) on the pituitary. The result is elevation of prolactin levels up to 200 ng/mL.
A: inhib