UKMLA PLAB AMC USMLE Prometric MCQ

Question Number 10
Question:
A 40 year old female presents to her physician with a goitre. On examination, the physician finds signs suggestive of acromegaly including coarse oily skin, a large tongue, prognathism and a prominent supra-orbital ridge of the face. Examination of the hands revealed thick ,spade fingers. Which of the following should be the initial hormonal diagnostic investigation

a) insulin levels
b) growth hormone
c) arginine levels
d) growth hormone releasing hormone
e) insulin-like growth factor 1 (IGF-1)