Epigastric Pain and Nausea

🗒️ Question

A 52 year old woman with acromegaly is started on octreotide for disease control after unsuccessful pituitary surgery. She presents to her GP after 6 months with complaints of recurrent upper abdominal pain, nausea and occasional vomiting.

On examination, her abdomen is soft with tenderness in the epigastrium. There is no guarding or rebound tenderness.

Investigations

• Serum amylase: 210 U/L (25–125)

• Liver function tests: Normal

What is the most likely side effect of her medication?

(A) Hepatic steatosis

(B) Gallstone formation

(C) Renal impairment

(D) Hyperglycaemia

(E) Hypothyroidism