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Acromegaly (Growth Hormone Excess)

by Carlo Raj, MD
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    With growth hormone excess and acromegaly, take a look at your patient up above and to the right and we have frontal bossing. If you take a look at the frontal area, you’ll find that the bone is protruding forward and you can actually notice prognathism in this patient as well. Look at the jaw, extremely well demarcated. You take a look at the patient down below and you find exaggerated prognathism in the patient that has acromegaly. Excessive sweating; with all these growth hormone in an adult, you can then expect there to be hyperglycemia; there might be Carpal tunnel syndrome because of excess, as we’ve said, soft tissue issues… growth, growth, growth; high incidence of colon polyps co-relate with skin tags on exam and that’s something that you want to pay attention to from a clinical point of view. Remember, acromegaly, you’re thinking about the internal organs that are growing including bones, the viscera, maybe the tongue, maybe the frontal bone, maybe the jaw and hyperglycemia. Cardiovascularly, this is a patient that may then die from it. Acromegaly, what we’re seeing here is the following. We have two leads of an ECG in which you are then going to identify your patient with heart issues. Watch this, here’s V1, how in the world… you’re thinking to yourself, “You’re really going to tie in electrocardiogram with what’s going on here with acromegaly, Dr. Raj?” I have to. What do we say would be perhaps a common cause of death in acromegaly? Heart disease. So, this is not a joke. Tell me the size of your heart perhaps in a patient with acromegaly. Good, it is going to be enlarged. So, how would you go about identifying this? Take a look at V1, V1 in this patient. V1 is a...

    About the Lecture

    The lecture Acromegaly (Growth Hormone Excess) by Carlo Raj, MD is from the course Pituitary Gland Disorders.


    Included Quiz Questions

    1. Sudden onset
    2. Sleep apnea
    3. Carpal tunnel syndrome
    4. Colon polyps
    5. Excessive sweating
    1. Left axis deviation
    2. Left ventricular hypertrophy
    3. Poor R wave progression
    4. Peaked T waves
    5. Q waves
    1. Bilateral involvement of inner ear structures
    2. Invasion of lesion into left cavernous sinus
    3. Encasement of internal carotid artery by lesion
    4. Superior bowing of the optic chiasm
    5. Bitemporal hemianopsia
    1. Non-suppressed GH levels 30 and 60 minutes after glucose challenge
    2. Increased IGF immediately after glucose challenge
    3. A spike in GH levels after 30 minutes that then decline before 60 minutes
    4. Increased somatostatin in response to glucose
    5. Marked hypoglycemia due to GH increased after glucose challenge
    1. Pegvisomant
    2. Cabergolin
    3. Octreotide
    4. Somatostatin analogue
    5. Radiation

    Author of lecture Acromegaly (Growth Hormone Excess)

     Carlo Raj, MD

    Carlo Raj, MD


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