A 43-year-old man presents with progressive coarsening of facial features and hand enlargement over 5 years. Vital signs show BP 148/92 mmHg, HR 88/min, RR 16/min, temperature 37°C. Random serum growth hormone level is 2.1 ng/mL (often normal). Fasting glucose is elevated at 118 mg/dL. Physical examination reveals no galactorrhea. Which of the following is the best next test to confirm acromegaly?
- A)24 hour urinary catecholamines
- B)Water deprivation test
- C)Cosyntropin stimulation test
- D)Serum ACTH level
- E)Measure IGF 1 levelGABARITO
Explicação
IGF 1 is the best screening and confirmatory biochemical marker for acromegaly because it reflects integrated growth hormone secretion and is more stable than random GH levels. If elevated, an oral glucose suppression test can further support the diagnosis. Ac... Ver explicação completa e trilha adaptativa →