Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
24 Cards in this Set
- Front
- Back
|
Acromegaly is most often caused by
|
Acromegaly is most often caused by a GH-secreting adenoma.
|
|
|
If GH excess occurs before epiphyseal closure, a condition known as
|
If GH excess occurs before epiphyseal closure, a condition known as pituitary gigantism results; when it occurs in adulthood after epiphyseal closure, acromegaly ensues. C
|
|
|
clinical features of acromegaly include
|
clinical features of acromegaly include prognathism; enlargement of the nose, lips, and tongue; frontal bossing; malocclusion; increased spacing between the teeth; sleep apnea; enlargement of the hands and feet; arthritis of the hips and knees; carpal tunnel syndrome; oily skin; and skin tags.
|
|
|
Prolactin is coproduced with GH in approximately 40% of patients with acromegaly. Some of these patients also may have
|
Prolactin is coproduced with GH in approximately 40% of patients with acromegaly. Some of these patients also may have amenorrhea and/or galactorrhea. Ectopic production of GH-releasing hormone is a rare (<1%) cause of acromegaly.
|
|
|
There is a two- to threefold increase in mortality rate associated with GH excess because of its association with
|
There is a two- to threefold increase in mortality rate associated with GH excess because of its association with cardiovascular and cerebrovascular diseases.
|
|
|
occur in many patients with GH excess
|
Cardiac hypertrophy is common, and hypertension and diabetes mellitus occur in many patients with GH excess.
|
|
|
Because of an increased risk of premalignant polyps and colon cancer, what shall be done
|
Because of an increased risk of premalignant polyps and colon cancer, screening with colonoscopy is recommended for all persons with GH excess
|
|
|
is needed for making the diagnosis.
|
Random GH level measurements are not useful because of pulsatile secretion, and demonstration of nonsuppression during a glucose tolerance test is needed for making the diagnosis.
|
|
|
screening test for acromegaly.
|
IGF-1 levels provide an integrated index of GH production, correlate well with clinical activity, and serve as a better screening test for acromegaly.
|
|
|
evaluates the extent of tumor growth;
|
An MRI evaluates the extent of tumor growth; approximately 60% of patients have macroadenomas.
|
|
|
Medical therapies are used in patients who are
|
Medical therapies are used in patients who are not cured by surgery or in whom surgery is very unlikely to result in a cure.
|
|
|
cabergoline /somatostatin
|
Although cabergoline is successful in only approximately 10% to 20% of patients with GH excess, an initial trial may be warranted because it can be given orally and is relatively inexpensive compared with somatostatin analogues.
|
|
|
somatostatin analogues
|
somatostatin analogues octreotide and lanreotide can be given by injection every 4 weeks and reduce GH and IGF-1 levels to normal in approximately 60% of patients.
|
|
|
Adverse effects of somatostatin analogues
|
Adverse effects of somatostatin analogues include diarrhea and an increased risk of cholelithiasis; cholecystitis and the need for cholecystectomy occur rarely.
|
|
|
Pegvisomant i
|
Pegvisomant is a biosynthetic GH analogue that prevents binding of GH to its receptor. It has been shown to normalize IGF-1 levels in more than 90% of patients with GH excess, with corresponding clinical benefits, but has no effects on tumors. Pegvisomant is given by daily injection; long-term experience with its use is limited.
|
|
|
Adjunctive radiation therapy
|
Adjunctive radiation therapy may be required when elevated GH levels or mass effects persist after surgery and medical therapy.
|
|
|
d
|
|
|
|
f
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
