Question

In acromegaly, the patient is likely to have which of the following?
1. Impaired glucose tolerance
2. Galactorrhoea
3. Hypertension
4. Suppression of growth hormone with glucose
Which of these statements are correct?

• A. 1, 2 and 4
• B. 2, 3 and 4
• C. 1, 3 and 4
• D. 1, 2 and 3

Hint:

Recall what a glucose load normally does to growth hormone, and whether that still happens in acromegaly.

Answer 1

The Correct Option is D

Acromegaly comes from too much growth hormone after growth plates have closed, usually from a pituitary tumor. We need to check which of the four listed features truly happen in this condition.

1. Impaired glucose tolerance: Growth hormone blocks insulin action on tissues, so blood sugar control worsens. This is a real feature.
2. Galactorrhoea: The tumor causing acromegaly often makes extra prolactin too, or presses on the pituitary stalk, both of which raise prolactin and cause milk discharge. This is a real feature.
3. Hypertension: Growth hormone makes the kidneys hold on to salt and water, raising blood pressure. This is a real feature.
4. Suppression of growth hormone with glucose: In a healthy person, drinking glucose switches off GH release. In acromegaly, this switch off does not work, GH output stays high. So this is not a feature the patient shows, it is the opposite of what happens, and doctors use this failed suppression as a diagnostic test.

Since three of the four, impaired glucose tolerance, galactorrhoea and hypertension, genuinely occur in acromegaly, while GH failing to suppress is what really happens, the correct combination is 1, 2 and 3.

Let's summarize:

• Acromegaly causes insulin resistance, high prolactin effects, and salt retention leading to hypertension.
• GH does not switch off with glucose in acromegaly, and this failure is used to diagnose the disease.

So the correct answer is 1, 2 and 3.