Diabetes Mellitus USMLE Step 1 Practice Question
A 46-year-old man with poorly controlled hypertension (BP 168/102 mmHg) reports progressive enlargement of his hands and feet requiring larger shoe sizes over 3 years, along with intermittent headaches. Examination reveals frontal bossing, prognathism, and coarse facial features. Laboratory studies show elevated insulin-like growth factor 1 (850 ng/mL; normal <200) and fasting glucose 128 mg/dL. Notably, no visual field defects are documented on screening. Which of the following is the best next diagnostic test to confirm the disorder?
Answer choices
- AOral glucose tolerance test showing failure of growth hormone suppressionCorrect answer
- B24-hour urine catecholamine measurement
- CLow dose dexamethasone suppression test
- DWater deprivation test
- EACTH stimulation test
- FThyroid-stimulating hormone level with free thyroxine measurement
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