Acromegaly OSCE Examination Quiz

Focused SBA-style practice, followed by the answer and explanation for every question.

Free now: 7 questions
Full bank: 54 questions
Answers: Explained

Free question

Try one with the answer

A question from this quiz. Answer it to see the explanation students get.

In acromegaly, which mechanism best explains the associated hypertension?

A Growth hormone increases thyroid hormone secretion, raising cardiac output and blood pressure
B Growth hormone increases red blood cell production, raising blood viscosity and total peripheral resistance
C Growth hormone makes the kidneys hold on to sodium and fluid and raises blood vessel tone ✓
D IGF-1 causes left ventricular hypertrophy, increasing stroke volume and blood pressure
E Growth hormone raises the blood calcium concentration, causing vascular smooth muscle contraction

The answer is C: Growth hormone makes the kidneys hold on to sodium and fluid and raises blood vessel tone

Explanation

Why C is correct

See Arms and Blood Pressure. Option C is correct. In acromegaly the pituitary gland makes too much growth hormone (GH), which drives the liver to make IGF-1 (insulin-like growth factor 1, the hormone that mediates most of growth hormone's effects). Hypertension is common and arises from a combination of two effects. GH has an anti-natriuretic effect on the kidney, which means that the kidney keeps sodium instead of passing it in the urine, and water follows the sodium so the fluid volume rises. GH is also associated with increased vascular tone (the baseline tension in the walls of the blood vessels). Hypertension contributes substantially to the cardiovascular illness of acromegaly, so you offer to measure the blood pressure when you examine the arms. A plain-language aid: growth hormone makes the kidney hold on to salt and tightens the vessels, so the pressure goes up.

Hormones: excess growth hormone drives the liver to make IGF-1.
Kidney: growth hormone has an anti-natriuretic effect, so sodium is kept and water follows.
Vessels: growth hormone is also associated with increased vascular tone.
Result: hypertension, which adds to the cardiovascular illness of acromegaly.

Why the other options are incorrect

A. Growth hormone increases thyroid hormone secretion, raising cardiac output and blood pressure: Growth hormone does not increase thyroid hormone secretion. Thyroid hormone excess can raise cardiac output, but that is not the mechanism of acromegalic hypertension.
B. Growth hormone increases red blood cell production, raising blood viscosity and total peripheral resistance: Growth hormone does not raise blood pressure by increasing red cell mass. The hypertension of acromegaly is driven by sodium and fluid retention in the kidney and increased vascular tone.
D. IGF-1 causes left ventricular hypertrophy, increasing stroke volume and blood pressure: Left ventricular hypertrophy is a consequence of acromegalic cardiomyopathy, not the cause of the associated hypertension. The blood pressure rises because of sodium retention and increased vascular tone.
E. Growth hormone raises the blood calcium concentration, causing vascular smooth muscle contraction: Growth hormone does not raise the blood calcium concentration. Calcium-induced vasoconstriction is not the mechanism of hypertension in acromegaly.

Easy

With Premium, questions you miss become Revision Coach flashcards, scheduled for review.

Question preview

What you will practise

More questions from this set. Start the quiz to answer them and see each explanation.

1
A 34-year-old woman with suspected untreated acromegaly is examined. The clinician listens at the lung bases for crackles and checks the ankles for swelling. Which underlying cause most directly explains why these signs are looked for?
2
A patient examined for acromegaly has enlarged hands, coarse facial features and a large tongue. What is the most appropriate way to complete the examination?

Need wider coverage?

Explore every OSCE topic set, or build a tailored mixed session.

Browse subject quizzes