19 Questions
Which of the following is NOT a effect of growth hormone stimulation via GHRH?
Decreased insulin sensitivity
Which of the following can be used to test growth hormone release?
Clonidine
Which of the following is a symptom of growth hormone deficiency in adults?
Subcutaneous & visceral adiposity
Which hormone stimulates milk production and secretion?
Prolactin
Which hormone stimulates smooth muscle contraction and uterine contractions?
Oxytocin
Which hormone stimulates water reabsorption in principal cells of collecting ducts and arteriolar constriction?
Vasopressin
Which hormone stimulates estrogen synthesis, follicular development, and sperm maturation?
Follicle-stimulating hormone
Which drug is a weak CYP3A4 inducer and weak CYP2A6 inhibitor?
Pasireotide
Which drug blocks cortisol effects at the glucocorticoid receptor?
Mifepristone
Which drug is a mineralocorticoid receptor blocker and also blocks androgen receptors?
Spironolactone
Which drug is a selective mineralocorticoid receptor blocker and does not cause gynecomastia?
Eplerenone
Which of the following medications inhibits renal prostaglandin synthesis and increases the ability to concentrate urine?
NSAIDs (primarily indomethacin)
Which of the following is a treatment option for Syndrome of Inappropriate ADH (SIADH)?
All of the above
Which medication is used in the treatment of Cushing's Syndrome by blocking 11β-hydroxylase?
Ketoconazole
Which medication is approved as a diagnostic agent for ACTH dependent adrenal insufficiency and can be used in the treatment of Cushing's Syndrome by inhibiting 11-hydroxylase?
Metyrapone
Which of the following is a treatment option for Acromegaly?
Pegvisomant (Somavert®)
What is the primary treatment for acromegaly?
Transsphenoidal surgery
Which hormone is responsible for gigantism in children before puberty?
Growth Hormone (GH)
What is the function of Somatostatin analogs in the treatment of acromegaly?
Bind to somatostatin receptors and inhibit GH production
Study Notes
Treatment Options for Acromegaly and Vasopressin Deficiency
- Insulin-Like Growth Factor (IGF-1) acts as an insulin sensitizer and decreases blood glucose levels.
- Primary IGF-1 Deficiency can be treated with Mecasermin (Increlex®), a recombinant IGF-1 administered subcutaneously.
- GH Excess in children before puberty can cause gigantism due to stimulation at the epiphyseal plates.
- GH Excess in adults (Acromegaly) can cause bone changes, enlargement of hands and feet, insulin resistance, and neuropathies.
- Acromegaly can be diagnosed through CT/MRI imaging, elevated GH levels, elevated IGF-1 levels, and heel pad thickness.
- Transsphenoidal surgery is the primary treatment for acromegaly, with radiation as an adjunctive therapy in some cases.
- Somatostatin analogs (Octreotide, Lanreotide, and Pasireotide) are used as medical therapy for acromegaly.
- Somatostatin analogs bind to somatostatin receptors and inhibit GH production.
- Pegvisomant (Somavert®) is a GH receptor antagonist used to treat acromegaly.
- Dopamine agonists (Cabergoline, Bromocriptine) can decrease GH production in a small percentage of acromegaly patients.
- Vasopressin acts on V2 receptors in the collecting ducts of the kidney to initiate an intracellular cascade and increase water permeability.
- Arginine Vasopressin Deficiency (AVP-D) and Arginine Vasopressin Resistance (AVP-R) are conditions that affect the body's ability to concentrate urine, leading to polyuria, nocturia, and polydipsia. Treatment options include replacing fluid losses and decreasing urine output. Desmopressin (DDAVP®) can increase water permeability in renal tubular cells to decrease urine volume.
Test your knowledge on treatment options for two different conditions - Acromegaly and Vasopressin Deficiency. Learn about medications, surgical interventions, and other therapies used to manage these conditions.
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