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Medicine

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Endocrine

Question
16 out of 20
 

Ramkali bai, a 35 year old female presented with one year history of menstrual irregularity and galactorrhea. She also had off-and-on headache. Her examination revealed bitemporal superior quadrantopia. Her fundus examination showed primary optic atrophy. Which of the following is the most likely diagnosis in this case: (AIPG 2010)



A Craniopharyngioma

B Pituitary macroadenoma

C Ophthalmic ICA aneurysm

D Chiasmal glioma

Ans. B

Pituitary macroadenoma

ACROMEGALY (Hari-18th ed. Pg- 2893)

1). Almost always due to pituitary adenoma secreting growth hormone

2). If GH secretion occurs in childhood prior to skeletal epiphyseal closure it leads to gigantism

3). If secretion begins after epiphyseal closure it leads to acromegaly.

Clinical Feature

1). There is excessive growth of hands, feet

2). Jaw(prognathism)

3). Voice deepening

4). Joint erosions

5). Carpal tunnel syndrome

6). Visceromegaly.

7). Proximal muscle weakness.

Local effects of pituitary tumor-amenorrhea, headaches, visual field loss, weakness.

Complications

1). DM as GH is counter-regulatory to insulin

2). Vascular: BP, LVH, cardiomyopathy.

3). Malignancy: development of colon cancer;

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