رجل عمره ٤٨ سنة لاحظ أن مقاس حذائه وخاتمه زاد، وملامح وجهه صارت أخشن، وفكه بارز، ويتعرق كثيراً، وعنده سكري حديث. ما الحالة الأرجح؟

A 48-year-old man notices his shoe and ring sizes have increased, his features have coarsened with a prominent jaw, he sweats a lot and has new diabetes. What is the likely condition?

1. Hypothyroidism
2. Paget’s disease of bone
3. Cushing’s syndrome
4. Acromegaly

Answer: D) Acromegaly. Excess GH after puberty enlarges hands, feet and facial features with sweating, diabetes and hypertension, usually from a pituitary adenoma; IGF-1 is measured.