Sample interview questions: How do you approach the treatment of patients with growth hormone excess in children?
Sample answer:
- Diagnose and confirm growth hormone excess through:
- Clinical evaluation: Assess for signs of acromegaly, including enlarged hands, feet, and facial features.
- Biochemical evaluation: Measure growth hormone (GH) levels, insulin-like growth factor-1 (IGF-1) levels, and glucose tolerance.
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Imaging studies: Perform magnetic resonance imaging (MRI) of the pituitary gland to identify a pituitary tumor (if present).
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Medical management:
- Somatostatin analogs (octreotide or lanreotide): These medications suppress GH secretion and can reduce symptoms and tumor size.
- Dopamine agonists (cabergoline or bromocriptine): These medications can reduce GH secretion in some patients.
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Pegvisomant: This medication is a GH receptor antagonist that blocks the effects of GH at the cellular level. It is used in patients who do not respond to somatostatin analogs or dopamine agonists.
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Surgical management:
- Transsphenoidal surgery: This minima… Read full answer
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