A man with headaches, enlarging hands and a coarse face is suspected of acromegaly. What is the diagnostic test?
Answer and explanation
Correct answer: B. Growth hormone during a glucose tolerance test, with IGF-1
- Step 1: Growth hormone is secreted in pulses, so random levels are unhelpful. Step 2. In normal people glucose suppresses growth hormone, but not in acromegaly, and IGF-1 reflects average GH exposure. Answer: Growth hormone during a glucose tolerance test, with IGF-1. Why not the others: Dexamethasone testing assesses cortisol. Thyroid tests would not diagnose this. Prolactin is relevant if there is a co-secreting adenoma.
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