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Acromegaly Examination

Acromegaly examination and questions for medical student exams, finals, OSCEs and MRCP PACES



  • Wash your hands
  • Introduce yourself
  • Identity of patient – confirm
  • Permission (consent and explain examination)
  • Pain?
  • Position at 45°
  • Privacy
  • Expose chest fully


General Inspection

  • Surroundings
    • Monitoring (possible arrhythmia secondary to cardiomyopathy); sliding scale (diabetes); walking aids (arthropathy)
  • Patient
    • Well or unwell?
    • Voice (deep and slow)


Systemic examination

  • Hands
    • Inspect
      • Large hands; coarse, sweaty skin
      • Diabetic finger prick marks
      • Clubbing
      • Signs of carpal tunnel syndrome (scars of decompressive surgery or clinical signs – e.g. wasting of thenar eminence)
    • Palpate
      • Pulse
  • Arms
    • BP (hypertension)
    • Ulnar nerve thickening
  • Neck
    • Goitre (increased thyroid vascularity)
    • Acanthosis nigricans
  • Face
    • Prominent supraorbital ridges; large nose and lips
    • Prognathism (prominent mandible)
    • Splaying of teeth
    • Macroglossia
    • Scars from previous surgery
  • Eyes
    • Visual fields (looking for bitemporal hemianopia)
    • Fundoscopy (papilloedema secondary to raised ICP)
  • Chest
    • Feel for displaced apex
    • Listen for murmur
    • Listen to lung bases if any suspicion of heart failure
  • Abdomen
    • Organomegaly
  • Legs
    • Proximal myopathy (ask patient to stand with arms crossed)
    • Peripheral oedema (if associated heart failure heart failure)



  • Thank patient
  • Patient comfortable?
  • Help getting dressed?
  • Wash hands
  • Turn to examiner, hands behind back, holding stethoscope (try not to fidget!) before saying: “To complete my examination, I would like to…”
    • Take a full history and possibly look at old photos of the patient
    • Bedside Investigations
      • Capillary blood glucose
      • Urine dip
      • ECG
    • Further Investigations


Click here for medical student OSCE and PACES questions about Acromegaly Examination

Common Acromegaly Examination exam questions for medical students, finals, OSCEs and MRCP PACES