Tuesday, November 18, 2008

Acromegaly in MRCP

Acromegaly in MRCP

Acromegaly is always a popular case in MRCP PACES but I think it is an important endocrine illness as well in MRCP Part 1 and 2.

OK, acromegaly is an endocrine disorder with excessive growth hormone, I think everyone knows about that. The name ‘acromegaly’ comes the Greek words for “extremities” and “enlargement,” reflecting one of its most common symptoms—the abnormal growth of the hands and feet. It is easy to diagnose acromegaly in paediatrics patients ( because patients will present with gigantism) however, sometimes you might miss acromegaly in adult group.

Acromegaly is a popular case in MRCP PACES short station. However, for MRCP Part 1 and 2, common questions will be as below,

1) Ways to diagnose acromegaly

Always remember that you need OGTT first and later to confirm with Growth Hormone level. You may need to check insulin-like growth factor 1 (IGF-1). MRI brain is useful as well!

2) Picture test


They like to show you a picture and ask you about the diagnosis. I think no one should fail this because YOU SHOULD NEVER miss acromegaly in your life.


3) Symptoms and signs of acromegaly

Remember that patients may just present with hypertension or diabetes. And of course do not forget about loss of libido as well!

OK, about the treatment – just remember surgery or medical- classes of drug to be used-somatostatin analog and GH receptor antagonist