; "HERMLi0 VALDIZAN" NATIONAL

FACULTY OF iVIEDICINE
ACADEMIC PROFESSIONAL SCHOOL
"HUMAN MEDI CIN E"
HUANUCO - PERU

SUBJECT : Basic English

SPECIALTY : Human Medicine
QUIZ 01
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ACROMEGALY AND GIGANTISM•

Acromegaly is. a (ce_rf in wtl_ic,11 the. abnormal( release of a. particular chemical' frorn the pituftary gland. in.
the brain causes increased, growth in bone and soft tr,..r .ue, as well as •a variety of . other dis rturhances
throughout:the:body: This chemical released from the pituitary gland is called'' krowth hormone (GH).The
body((ability. to process and use nutrients likerfatS and sugars is also al -tered. In chil- d- ffn--\7vTose
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plates have not closed, the chemical cnanges of acromegaly re-suit in exceptional growth of long bones. This,/
variant is called gigantism, with the. additional bone growth causing unusual height. When the abnormality
occurs after bone growth stops, the disorder is. acrome.gaiy.. Acromegaiy is a relatively rare disorder,
occurring in approximately 5.0 out of every 1 million people (501: . 1,000,.G00). Both men and women are
affected. Because the symptoms of acromegaly occur so gradually, diagnosis is often delayed. The majority of
patients are not identified until' they are middle aged.
Causes and symptoms
The pituitary is a small gland located at the base . of the brain. A gland is a collection of cells that releases
certain chemicals, or hormones,.which are importzInt to thefunctioning of other organs or body systems. The
pituitary hormones travel throughout the body and are in ■lolVed.-in a large. number of activities, including the
regulation of growth and reproductive ,
functions. The cause of acromegaiy can be ttace'd to the pituitary's
production of GH. Under normal conditions, the pituitary receives input from another brain structure, the
hypothalamus, located at the base of the brain. This input from the hypothala mus regulates the pituitary's
release of hormones: For example, the hypothalamus produces growth hormone -releasing hormope fGHRH), ,
which directs the pituitary,to release GH. Input from the hypothalamus should also direct the pituitar
releasing hormones. In acromegaly, the pituitary continues - to release C.11-1 and ignores signals from the
hypothalamus. In the (.. - 3H causes production of "a hormone called insulin-like growth factor 1 (I.GF-T),
which is responsible for -- gr i owth throughout the body. When the pituitary refuses to stop producing GH, the
levels of lGF-1. -also reaCh - abnorrnal." peaks. Bones, soft tissue, and organs throughout the body begin to
enlarge and the body changes its ability to process and use nutrients like sugars and fats. in acronaegaly,,an
individual's hands and feet.begin to grow, becoming thick ancf - dodghy.iThe jaw . line, nose, and.fdrehead also
grow, and fecial feature3 are described as "r.oarseit ng." The.tongue grows larger, and because. the jaw is
larger, the teeth become more widely spacedi Due to SWelling wifhih the structures of the throat and sinuses,
the .voiCe. becomes deeper and and sounds rnpre,:libifow, and patients may deVelo .6 -loud SnOring'.\ Various
horrqpnal changes cause symptoms such as Heavy'sCie.ating,...OTY Skin, Increased -caat. s.e body ,hair, Improper
processing of sugars in the diet (and sometimes actual diabetesh High, blood pressure, Increased calcium in
the urine (sometimes leading to kidney stonesNIncreased 'riSk OT gallstones; and SWe.iirn4 of the thyroid
gland/ People with acrornegaly have more skin tags, or outgrOwths oftrs3uethan oormal. This increase in
skin tags is also associated with the development of growths, called POI ■ps, ■kithin the large intestine that
may eventually become. cancerous.IPatients with acromegaly often suffer from headaehe -s-and_arthatis, The
various swellings and enlargements throughout the body . may press on nerves, causing sensations of local
tingling or burning, and sometimes result in muscle w'6akries. The most common cause of this disorder (in
90% of patients) is the devetopment of a noncancerous tumor within the _pituitary, called a pituitary
adenoma. These tumors are the source OT the abnormal release of As these tumors grow, they may press
on nearby structures within the brain, causing headaches and changes in vision. As the adenoma grows, it
may diSrUpt other pituitary tissue, interfering with the release of other hormones. These (lisruptions. _Ma yile
responsible for changes in the menstrual cycle of women, decreases in the sexual drive , in men and women,
and the abnormal production of breast milk in women. In rare cases, acromegaly is caused by the abnormal
production of growth hormone-releasing hormone (C_ThRH), which leads to the increased production of GH.
Certain tumors in the pancreas, lungs, adrenal glands, thyroid, and intestine produce GHRH, which in turn
triggers production of an abnormal - quantity of Gi-i.