<prompt> Which of these tests is the first to be performed in a patient with the following presentation?ABG samplingIGF- 1 levelsRA factorHLA- B27 levels  <response>: IMAGE : SPADE LIKE DEFORMITY OF HANDS: Seen in ACROMEGALY Screening test done: IGF -1 IOC: Glucose challenge test GCT Treatment: Surgery Transphenoidal Resection If recurrence seen: PEGVISOMANT 