3BDS: Endocrinology 4

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what does GH do and how
GH stimulates body growth by causing the liver to release insulin-like GF1
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What does IGF-1 do
increases collagen and protein synthesis and other growth promoting actions particularly in bones
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what does GH in adults cause
acromegaly
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what are the majority of cases of acromegaly due to
due
to pituitary adenoma secreting GH
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what are the feats of acromegaly
widening and coarsening of bones and growth of soft tissues
 Joint problems, arthritis, hypertension and glucose intolerance or diabetes
bigger hands/feet, visual deterioration, goitre , polyuria, large tongue, interdental spacing , prominent supraorbi
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Facial features in acromegaly
• Interdental separation
• Macroglossia
• Prognathism
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Management of acromegaly- very specialist
Trans-sphenoidal surgery to remove adenoma
If persistent disease post op, medical therapy to suppress
If medial therapy fails, consider stereotactic radiotherapy to residual adenoma
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how is acromegaly diagnosis made
 Diagnosis made on measurement of plasma GH and IGF-1, often with brain imagining to look for pituitary adenoma
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what physiological effects does GH have
via liver release of IGF-1 causes skeletal and soft tissue growth
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What does IGF-1 do

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increases collagen and protein synthesis and other growth promoting actions particularly in bones

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what does GH in adults cause

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what are the majority of cases of acromegaly due to

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what are the feats of acromegaly

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