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Acromegaly — RCPSC IM MCQ

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ModerateEndocrinologyAcromegalyRCPSC IM

A 44-year-old man has enlarging hands, new mandibular spacing of teeth, sweating and worsening sleep apnea. Fasting glucose is 8.4 mmol/L and blood pressure is 152/92 mm Hg. His partner notes his facial features have changed over several years. What is the most appropriate investigation?

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Correct answer: E — Serum IGF-1

IGF-1 is the preferred screening test for suspected acromegaly because random growth hormone is pulsatile. Abnormal IGF-1 is followed by confirmatory testing and pituitary imaging.

Reference: Endocrine Society acromegaly guideline; Canadian endocrine practice