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

Step 1: Understanding the Question.
Acromegaly is caused by too much growth hormone (GH) in adults, usually from a pituitary adenoma. The question asks which of four features actually happen in this disease.

Step 2: Key Concept.
Excess GH pushes the liver to make more insulin like growth factor 1, and both GH and this factor reduce how well insulin works in the body, giving impaired glucose tolerance. GH also raises blood pressure by making the body hold on to sodium and water. Many GH secreting pituitary tumors also leak some prolactin or press on the pituitary stalk, and this raised prolactin causes galactorrhoea, a milky discharge from the breast.

Step 3: Detailed Explanation.
Statement 1, impaired glucose tolerance: correct, since GH excess causes insulin resistance.
Statement 2, galactorrhoea: correct, since prolactin often rises alongside GH in these tumors.
Statement 3, hypertension: correct, since GH promotes sodium and water retention.
Statement 4, suppression of growth hormone with glucose: this describes the normal body response, where giving glucose should switch off GH release. In acromegaly this switch off fails, GH stays high even after glucose. This failure of suppression is in fact the classic test used to diagnose acromegaly, so this statement does not describe what the patient actually shows.

Step 4: Final Answer.
The correct features are 1, 2 and 3.