An overgrowth of bone and soft tissue is seen in ?

RRB Nsg. Superintendent-21 July 2019 (Shift-2nd)

Medical & Surgical Nursing

Easy

Appeared in: RRB Nsg. Superintendent-21 July 2019 (Shift-2nd)

Explanation

Acromegaly is a hormonal disorder caused by the hypersecretion of Growth Hormone (GH) in adults, typically from a pituitary adenoma.
The term 'acro' refers to extremities, and 'megaly' means enlargement, highlighting the characteristic feature of this condition.
Excess GH after the closure of bone growth plates leads to the thickening and enlargement of bones and soft tissues, particularly in the hands, feet, and face.
Clinical manifestations include prognathism (protruding jaw), enlarged hands and feet, thickened skin, and enlargement of internal organs.

Option B: Cushing's syndrome is caused by prolonged exposure to high levels of cortisol, not growth hormone. It leads to fat redistribution (central obesity, moon face, buffalo hump) and catabolic effects like muscle wasting and skin thinning, not bone and soft tissue overgrowth.
Option C: Goitre is the specific term for an enlarged thyroid gland. It is a localized swelling in the neck and does not cause generalized overgrowth of bone and soft tissue throughout the body.
Option D: Tetany is not a disease but a clinical sign characterized by involuntary muscle contractions and spasms. It is most commonly caused by hypocalcemia (low blood calcium levels) and is unrelated to hormonal overgrowth of tissues.

Visual 1: Comparative Images - Show side-by-side photos of a person's face and hands before and after the onset of acromegaly to illustrate the gradual changes like coarsening of facial features, prognathism, and enlargement of hands.
Visual 2: Diagram - A simple flowchart showing 'Pituitary Adenoma' → 'Excess Growth Hormone (in adults)' → 'Acromegaly' → 'Bone & Soft Tissue Overgrowth'.
Visual 3: Infographic - An infographic comparing the key features of Acromegaly (GH excess) and Cushing's syndrome (Cortisol excess) to highlight the differences in physical appearance.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Endocrine disorders and their manifestations as background academic context rather than a clinical decision trigger.
Early recognition of acromegaly is crucial for nurses, as the changes are often slow and insidious. Noticing enlarged hands/feet (e.g., patient reporting changes in ring or shoe size) or facial changes can prompt investigation.
Patients with acromegaly require lifelong monitoring for complications such as diabetes mellitus (due to GH's insulin-antagonistic effect), hypertension, heart failure, and sleep apnea.
Nursing care involves significant psychosocial support, as the changes in physical appearance can lead to severe body image disturbances and depression.

How to Approach the Question

First, identify the key phrase in the question: 'overgrowth of bone and soft tissue'. This points to a condition involving excessive growth.
Next, analyze the options, which are all endocrine-related conditions or signs.
Recall the primary hormone and effect of each condition. Acromegaly is linked to excess growth hormone.
Evaluate how each condition affects growth. Cushing's syndrome involves cortisol and fat redistribution. Goitre is localized thyroid swelling. Tetany is a symptom of low calcium.
Conclude that Acromegaly is the only option that matches the description of generalized overgrowth of both bone and soft tissue in an adult.

Concept Tested & Keywords

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