00:00 / 00:00




Endocrine system

Adrenal gland disorders

Congenital adrenal hyperplasia

Primary adrenal insufficiency

Waterhouse-Friderichsen syndrome


Adrenal cortical carcinoma

Cushing syndrome

Conn syndrome

Thyroid gland disorders

Thyroglossal duct cyst


Graves disease

Thyroid eye disease (NORD)

Toxic multinodular goiter

Thyroid storm


Euthyroid sick syndrome

Hashimoto thyroiditis

Subacute granulomatous thyroiditis

Riedel thyroiditis

Postpartum thyroiditis

Thyroid cancer

Parathyroid gland disorders





Pancreatic disorders

Diabetes mellitus

Diabetic retinopathy

Diabetic nephropathy

Pituitary gland disorders


Pituitary adenoma






Growth hormone deficiency

Pituitary apoplexy

Sheehan syndrome


Constitutional growth delay

Diabetes insipidus

Syndrome of inappropriate antidiuretic hormone secretion (SIADH)

Gonadal dysfunction

Precocious puberty

Delayed puberty

Premature ovarian failure

Polycystic ovary syndrome

Androgen insensitivity syndrome

Kallmann syndrome

5-alpha-reductase deficiency

Polyglandular syndromes

Autoimmune polyglandular syndrome type 1 (NORD)

Endocrine tumors

Multiple endocrine neoplasia

Pancreatic neuroendocrine neoplasms

Zollinger-Ellison syndrome

Carcinoid syndrome



Opsoclonus myoclonus syndrome (NORD)

Endocrine system pathology review

Adrenal insufficiency: Pathology review

Adrenal masses: Pathology review

Hyperthyroidism: Pathology review

Hypothyroidism: Pathology review

Thyroid nodules and thyroid cancer: Pathology review

Parathyroid disorders and calcium imbalance: Pathology review

Diabetes mellitus: Pathology review

Cushing syndrome and Cushing disease: Pathology review

Pituitary tumors: Pathology review

Hypopituitarism: Pathology review

Diabetes insipidus and SIADH: Pathology review

Multiple endocrine neoplasia: Pathology review

Neuroendocrine tumors of the gastrointestinal system: Pathology review




0 / 11 complete

USMLE® Step 1 questions

0 / 2 complete

High Yield Notes

13 pages



of complete


USMLE® Step 1 style questions USMLE

of complete

A 38-year-old woman comes to her primary care physician for evaluation of “changing facial features” that began seven-months ago. The patient describes that her forehead and jaw appear bigger than before. In addition, she endorses deepening of her voice and “being sweaty.” Past medical history is noncontributory. Temperature is 37.5°C (99.5°F), pulse is 72/min, respirations are 18/min, and blood pressure is 128/72 mmHg. As part of the work-up process, serum insulin-like growth factor 1 (IGF-1) levels are measured. In addition, growth hormone (GH) levels are measured before and after the administration of glucose. Which of the following sets of findings will most likely be seen in this patient?

External References

First Aid








Acromegaly p. 345

carpal tunnel syndrome p. 456

GH p. 340

octreotide for p. 409

somatostatin analogs for p. 335

somatostatin for p. 362

Diaphoresis p. 311

acromegaly p. 345

Heart failure p. 318

acromegaly p. 343

Insulin-like growth factor 1 (IGF-1)

acromegaly p. 343

Insulin resistance

acromegaly p. 345

Octreotide p. 380, 409

acromegaly p. 345

Pituitary adenomas

acromegaly and p. 343

External Links


Content Reviewers

Rishi Desai, MD, MPH


Sam Gillespie, BSc

Acromegaly can be broken down into “acro” which refers to extremity and “megaly” which refers to enlargement.

So acromegaly is a hormonal disorder in adults where there is an excess of growth hormone or somatotropin, and causes continued growth of the extremities in adults, leading to large hands, feet and face.

As examples, the French wrestler André the Giant who played Fezzik in the movie The Princess Bride and actor Richard Kiel who played Jaws in the James Bond movies both had acromegaly.

In children, excess growth hormone causes a different disorder, called gigantism, because their long bones haven’t stopped growing yet.

So let’s talk about how growth hormone is made.

Normally, the hypothalamus which is at the base of the brain, secretes growth hormone-releasing hormone in bursts throughout the day - every couple hours, and this can increase based on things like low blood glucose levels, lack of food, increased exercise, increased sleep, and increased stress like trauma.

The growth hormone-releasing hormone goes into the hypophyseal portal system - which is a network of capillaries linking the hypothalamus to the anterior pituitary which is smaller in size than a pea.

The growth hormone-releasing hormone binds to a surface protein on somatotroph cells of the anterior pituitary gland, and in response, they release growth hormone.

The body uses three main ways to help limit the amount of growth hormone that gets made.

First, too much growth-hormone-releasing hormone signals the hypothalamus to stop making more.


Acromegaly is a rare disorder caused by too much growth hormone (GH) secreted by the anterior pituitary gland, a small organ at the base of the brain. In children, too much GH can lead to gigantism condition characterized by unusually tall stature. In adults, too much GH can cause acromegaly, which results in abnormal enlargement of the head, face, hands, and feet. It is usually accompanied by comorbidities like diabetes mellitus, hypertension, heart disease, and arthritis.


  1. "Robbins Basic Pathology" Elsevier (2017)
  2. "Harrison’s principles of internal medicine" McGraw Hill / Medical (2018)
  3. "Pathophysiology of Disease: An Introduction to Clinical Medicine, 8e" McGraw Hill (2018)
  4. "Current Medical Diagnosis and Treatment 2020" McGraw Hill (2020)
  5. "Harrison's Endocrinology, 4E (Harrison's Specialty) 4th Edition" McGraw Hill (2016)
  6. "A consensus on the diagnosis and treatment of acromegaly complications" Pituitary (2012)
  7. "Surgery for acromegaly: Evolution of the techniques and outcomes" Reviews in Endocrine and Metabolic Disorders (2008)

Copyright © 2023 Elsevier, except certain content provided by third parties

Cookies are used by this site.

USMLE® is a joint program of the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME). COMLEX-USA® is a registered trademark of The National Board of Osteopathic Medical Examiners, Inc. NCLEX-RN® is a registered trademark of the National Council of State Boards of Nursing, Inc. Test names and other trademarks are the property of the respective trademark holders. None of the trademark holders are endorsed by nor affiliated with Osmosis or this website.