ACROMEGALY

ACROMEGALY

1. PRESENTATION

   • OVERGROWTH OF BONES AND TISSUES
   • CARDIAC ENLARGEMENT
   • HYPERTENSION
   • HEPATOMEGALY
   • LEFT VENTRICULAR HYPERTROPHY

2. HYPERSECRETION OF GH IN ADULTS

   • CHILDREN
     • GIANTISIM

3. TREATMENT

   • MEDICATIONS
     • DOPAMINE
       • suppresses GH secretion
     • Somatostatin (sandostatin)
       • Reduces GH levels
         • patient teaching for injections
           • subQ
           • IV
           • IM
         • side effects
           • gallbladder disease
   • STEREOTACTIC RADIATION THERAPY
   • LINEAR ACCELERATOR
   • GAMMA KNIFE
   • surgical
     • hypophysectomy
       • care
         • preoperative
           • antibiotic nose drops
           • teaching
             • avoid valsalva maneuver
             • avoid coughing and sneezing
             • mouth breathing only, nose will be packed
         • postoperative
           • HOB elevated
           • medicate for pain
           • no toothbrush
           • assess for nasal drainage
       • complications
         • CSF leak
           • positive for glucose
           • resolved with raised HOB
             • not resolved?
               • spinal tap to reduce pressure and for healing
           • risk for infection
         • infection
           • meningitis
             • headache?
             • fever?
             • muscle ridgitiy?
         • DI