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Acromegaly USMLE Notes & mnemonics contains all the high-yield points you need to know.


  • Acromegaly: A rare hormonal disorder caused by excess growth hormone (GH) production, usually due to a pituitary adenoma. (Ref)


  • GH Hypersecretion: Leads to liver producing more Insulin-Like Growth Factor 1 (IGF-1), promoting growth of bones and soft tissues.
  • Pituitary Adenoma: Most common cause.


  • Typically diagnosed in middle-aged adults.
  • Rare, with an incidence of about 3 per million per year.

Clinical Features:

  • Enlarged Hands and Feet
  • Coarse Facial Features: Prognathism, enlarged nose, lips, and tongue.
  • Macroglossia
  • Sweating and Skin Tags
  • Joint Pain and Arthritis
  • Carpal Tunnel Syndrome
  • Hypertension, Cardiomegaly
  • Impaired Glucose Tolerance/Diabetes


  • Elevated IGF-1 Levels: Reflects integrated GH levels.
  • Oral Glucose Tolerance Test (OGTT): Lack of GH suppression after glucose administration confirms diagnosis.
  • MRI of the Pituitary Gland: To detect adenoma.


  • Transsphenoidal Surgery: First-line for pituitary adenomas.
  • Somatostatin Analogs (e.g., Octreotide, Lanreotide): Reduce GH production.
  • GH Receptor Antagonists (e.g., Pegvisomant): Block GH effects.
  • Dopamine Agonists (e.g., Cabergoline): Reduce GH in some patients.
  • Radiation Therapy: For uncontrolled cases after surgery and medications.


  • Cardiovascular Disease
  • Sleep Apnea
  • Colon Polyps and Increased Risk of Colorectal Cancer
  • Hypopituitarism (post-treatment)


  • Normal life expectancy if adequately treated; increased mortality if untreated, primarily due to cardiovascular complications.

Mnemonic: “ACRO-MEGALY

  • Adults (commonly middle-aged)
  • Coarse facial features
  • Ring size increases (enlarged hands)
  • Organomegaly (heart, liver, etc.)
  • Macroglossia
  • Enlarged feet
  • Growth hormone excess
  • Arthralgia
  • Lanreotide & Octreotide (treatment options)
  • You see pituitary adenoma on MRI
Acromegaly mnemonic
Acromegaly mnemonic

Chart: Diagnostic Approach to Acromegaly

TestPurposeExpected Finding
IGF-1 LevelScreening testElevated
Oral Glucose Tolerance TestConfirmatory testFailure to suppress GH
MRI of PituitaryIdentify adenomaPituitary adenoma visible

Note: For the USMLE, focus on the classic presentation of acromegaly, including its insidious onset and distinctive physical changes. Recognize the importance of IGF-1 and OGTT in diagnosis and understand the first-line treatments and their purposes. Be aware of the complications and the need for lifelong follow-up due to the risk of tumor recurrence and development of comorbid conditions.

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