A 42-year-old man has a new diagnosis of hypertension and bilateral carpel tunnel syndrome. On examination, he is tall, with large and doughy hands. His facial features are coarse, and he has a prominent mandible with wide- spaced teeth. His voice is deep, and he has macroglossia. Heart examination reveals the apical impulse be displaced 2cm laterally. His family history is unremarkable. Which of the following is the most appropriate test to be done?
سؤال مجاني 1 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: A. IGF-1
Coarse facies, prognathism, macroglossia, large hands, carpal tunnel syndrome and hypertension suggest acromegaly; the best initial (screening) test is serum IGF-1. OGTT confirms and pituitary MRI localises afterwards; cortisol and prolactin test other syndromes.
ليش كل خيار صح أو غلط
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A
ليش صح
The diagnostic sequence for acromegaly starts with IGF-1 (the screening test), then the OGTT, then pituitary MRI.
✓ Pituitary summary.pdf · p. 2 -
B
ليش غلط
An insulin stimulation test is not in the acromegaly diagnostic sequence, which is IGF-1 (screening), then OGTT (GH fails to suppress), then MRI.
✓ Pituitary summary.pdf · p. 2 -
C
ليش غلط
24-hour urinary free cortisol screens for Cushing (moon facies, purple striae, thin skin); this patient's features are acromegaly.
✓ Pituitary summary.pdf · p. 3 -
D
ليش غلط
Prolactin is for a prolactinoma, which causes hypogonadism and galactorrhea; this is an acromegaly picture.
✓ Pituitary summary.pdf · p. 3 -
E
ليش غلط
MRI confirms the adenoma after IGF-1 and the OGTT show the biochemical disease, so it is not the first test.
✓ Pituitary summary.pdf · p. 2
- المصدر
- RT - Pituitary.pdf · p. 4
Pituitary summary.pdf · p. 2 - المحاضرة
- Pituitary Disorders · Endocrinology · Module B
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- Endo bank