Nokea
Regarding syndrome of inappropriate antidiuretic hormone (SIADH), which is true?
- A. Hyponatremia is dilutional
- B. Urine is relatively hypertonic to plasma
- C. ADH-mediated water reabsorption does not occur
- D. Renal function is jeopardized
Correct Answer: A
Rationale: In the syndrome of inappropriate antidiuretic hormone (SIADH), there is excessive secretion of antidiuretic hormone (ADH) leading to increased water reabsorption in the kidney tubules. This results in dilutional hyponatremia because the amount of water reabsorbed is greater than the electrolytes, such as sodium, leading to a relative decrease in their concentration in the blood. As a result, hyponatremia occurs in SIADH, contributing to symptoms such as nausea, confusion, and seizures due to the imbalance in electrolytes.
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All of the following are features of Conn's syndrome except:
- A. Alkalosis
- B. Hyperkalemia
- C. Muscle cramps
- D. Severe systemic hypertension
Correct Answer: B
Rationale: Conn's syndrome, also known as primary hyperaldosteronism, is characterized by excess production of aldosterone by the adrenal glands. This leads to increased sodium retention and potassium excretion in the kidneys. As a result, patients with Conn's syndrome typically present with hypokalemia (low potassium levels), not hyperkalemia (high potassium levels). The other features of Conn's syndrome include alkalosis (metabolic), muscle cramps, and severe systemic hypertension.
Neurological features of myxoedema include all of the following except:
- A. Delayed relaxation of ankle jerk
- B. Cerebellar ataxia
- C. Hypertonia
- D. Bradylalia
Correct Answer: B
Rationale: Myxoedema refers to severe hypothyroidism which can lead to neurological manifestations. The correct features associated with myxoedema include delayed relaxation of ankle jerk (Choice A), hypertonia (Choice C), and bradylalia (Choice D). Cerebellar ataxia, which involves incoordination and balance issues due to dysfunction of the cerebellum, is not a typical neurological feature seen in myxoedema.
Which of the following are causes of Addison's disease?
- A. Adrenoleukodystrophy
- B. Pyelonephritis
- C. Tuberculosis
- D. Autoimmune destruction of the adrenal cortex
Correct Answer: D
Rationale: Addison's disease, also known as primary adrenal insufficiency, is mainly caused by the autoimmune destruction of the adrenal cortex. This results in the inadequate production of hormones such as cortisol and aldosterone by the adrenal glands. While other conditions such as Adrenoleukodystrophy, Pyelonephritis, and Tuberculosis can also affect the adrenal glands, they are not known to be direct causes of Addison's disease.
Thyroid hormones (T3 and T4):
- A. increase metabolic rate.
- B. are hydrophilic as they are made from amino acids.
- C. contain iron atoms in ferrous form.
- D. stimulate the secretion of thyroid-stimulating hormone (TSH; thyrotropin).
Correct Answer: A
Rationale: Thyroid hormones, T3 (triiodothyronine) and T4 (thyroxine), play a crucial role in regulating metabolism in the body. They are responsible for increasing the metabolic rate of cells by influencing the production of proteins and controlling how the body uses energy. This increase in metabolic rate results in processes such as increased heart rate, enhanced nutrient breakdown, and higher body temperature. Thus, option A, "increase metabolic rate," is the correct statement regarding thyroid hormones (T3 and T4).
All the following are effects of hypercalcemia except
- A. Diarrhea
- B. Polyuria
- C. A shortened qt interval
- D. Nephrolithiasis
Correct Answer: C
Rationale: Hypercalcemia refers to elevated levels of calcium in the blood. The effects of hypercalcemia include increased urinary frequency (polyuria), gastrointestinal symptoms such as constipation rather than diarrhea, kidney stones (nephrolithiasis), and various cardiac abnormalities. One key cardiac abnormality associated with hypercalcemia is a prolonged QT interval rather than a shortened QT interval. Prolongation of the QT interval can predispose individuals to arrhythmias, particularly Torsades de pointes. Therefore, the correct answer is C, as a shortened QT interval is not a typical effect of hypercalcemia.