ESAT - Challenging Cases in the Management of Acromegaly

Endocrine Self-Assessment Tools (ESATs) are free online self-test activities. Challenging Cases in the Management of Acromegaly is a 9 multiple-choice question module with a rationale for each correct answer for additional learning.


The Endocrine Society is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The Endocrine Society has achieved Accreditation with Commendation.

The Endocrine Society designates this enduring material for a maximum of 1.75 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This activity is supported by an educational grant from Novartis Pharmaceuticals Corporation.

Target Audience

This continuing medical education activity should be of substantial interest to endocrinologists, endocrine fellows, and healthcare professionals who treat patients with acromegaly.

Learning Objectives

Upon completion of this enduring material, learners will be better able to:

  • Recommend appropriate therapeutic choices for women with acromegaly when headache develops during pregnancy.
  • Manage persistently elevated hormone levels and residual tumor in acromegaly after transsphenoidal surgery.
  • Manage a macroadenoma with little chance of cure surgically and explain that debulking surgery effectively increases cure rates with somatostatin analogues administered postoperatively.
  • Recommend an appropriate treatment modality in patients with acromegaly harboring parasellar invasive somatotropinomas.
  • Counsel patients on how treatment of acromegaly affects associated morbidity.
  • Manage patients with acromegaly after surgery and first-generation somatostatin analogues fail.
  • Explain the effects of various acromegaly treatments on glucose homeostasis.
  • Determine the indications for cabergoline treatment in patients with mild postoperative acromegaly.
  • Manage patients with acromegaly who have tumor remnant and active disease resistant to first-line somatostatin analogues.

Additional Information

Target Audience: 
Clinical researcher
Nurse/Nurse practitioner
Physician assistant
Allied health professional
Competency Area: 
Patient Care and Procedural Skills
Medical Knowledge
Practice-based Learning and Improvement
Topic Area: 
Neuroendocrinology and Pituitary
Level of Outcomes: 
Level 1 (Participation)
Level 2 (Satisfaction)
Level 3A (Learning: Declarative Knowledge (Knows))
Level 3B (Learning: Procedural Knowledge (Knows How))
Level 4 (Learning: Competence (Shows How))
Level 5 (Performance (Does))
Activity summary
Available credit: 
  • 1.75 AMA PRA Category 1 Credits
  • 1.75 CME Certificate of Participation
Course opens: 
Course expires: 

John A. H. Wass, MD – Program Director
Professor of Endocrinology
Oxford Center for Diabetes, Endocrinology and Metabolism
University of Oxford
Oxford, United Kingdom

Mônica R. Gadelha, MD, PhD
Universidade Federal do Rio de Janeiro
Instituto Estadual do Cérebro Paulo Niemeyer
Rio de Janeiro, Brazil

Mark E. Molitch, MD
Martha Leland Sherwin Professor of Endocrinology
Division of Endocrinology, Metabolism and Molecular Medicine
Northwestern University Feinberg School of Medicine
Chicago, Illinois


The faculty, committee members, and staff who are in position to control the content of this activity are required to disclose to the Endocrine Society and to learners any relevant financial relationship(s) of the individual or spouse/partner that have occurred within the last 12 months with any commercial interest(s) whose products or services are related to the CME content. Financial relationships are defined by remuneration in any amount from the commercial interest(s) in the form of grants; research support; consulting fees; salary; ownership interest (e.g., stocks, stock options, or ownership interest excluding diversified mutual funds); honoraria or other payments for participation in speakers' bureaus, advisory boards, or boards of directors; or other financial benefits. The intent of this disclosure is not to prevent CME planners with relevant financial relationships from planning or delivery of content, but rather to provide learners with information that allows them to make their own judgments of whether these financial relationships may have influenced the educational activity with regard to exposition or conclusion.

The Endocrine Society has reviewed all disclosures and resolved or managed all identified conflicts of interest, as applicable.

The faculty reported the following relevant financial relationship(s) during the content development process for this activity:
Mônica R Gadelha, MD, PhD: Advisory Board Member, Consultant, Research Grant Support and Speaker, Novartis Pharmaceuticals; Principal Investigator and Speaker, Ipsen; Research Grant Support, Pfizer, Inc.
Mark E Molitch, MD: Advisory Board Member, Chiasma; Consultant, Pfizer, Inc.; Investigator, Ipsen, Novartis Pharmaceuticals

The following faculty reported no relevant financial relationships:  John A H Wass, MD

The following SPC member who reviewed content for this activity reported relevant financial relationships:
Lisa Nachtigall, MD: Consultant, Genentech; Consultant and Principal Investigator, Ipsen

Available Credit

  • 1.75 AMA PRA Category 1 Credits
  • 1.75 CME Certificate of Participation