Nokea
A person with acromegaly usually has:
- A. prognathism and large fleshy lips.
- B. hypoglycemia.
- C. a growth hormone deficiency.
- D. protruding eye balls.
Correct Answer: A
Rationale: Acromegaly is a hormonal disorder that results from the overproduction of growth hormone (GH) in adulthood. One of the key physical characteristics associated with acromegaly is the enlargement of facial features. People with acromegaly often develop prognathism, which is a condition where the lower jaw protrudes forward, leading to a prominent lower face. Additionally, they may have large fleshy lips due to the soft tissue swelling that occurs as a result of excess GH. Other common signs of acromegaly include enlarged hands and feet, thickened skin, and joint pain.
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The triad of hyponatraemia, haemodilution and urine hypertonic to plasma suggest diagnosis of:
- A. Nephrotic syndrome
- B. SIADH
- C. Nephrogenic diabetes insipidus
- D. Addison's disease
Correct Answer: B
Rationale: The triad of hyponatremia (low sodium levels in the blood), haemodilution (increased plasma volume), and urine hypertonic to plasma (high urine osmolality compared to blood osmolality) is characteristic of Syndrome of Inappropriate Antidiuretic Hormone (SIADH). In SIADH, there is excessive release of antidiuretic hormone (ADH), also known as vasopressin, leading to water retention by the kidneys and dilutional hyponatremia. This condition results in the body holding onto water, causing hyponatremia and dilution of the blood. The urine being hypertonic compared to plasma indicates that the kidneys are reabsorbing water effectively and concentrating the urine.
Features of hypoglycaemia do not include:
- A. Drenching sweat
- B. Tachycardia
- C. Tachypnoea
- D. Brisk jerk
Correct Answer: D
Rationale: Hypoglycemia is characterized by a low blood sugar level, which can lead to various symptoms. The features of hypoglycemia typically include drenching sweat, tachycardia (increased heart rate), and tachypnea (rapid breathing). A brisk jerk, on the other hand, is not a typical feature of hypoglycemia. Symptoms such as confusion, dizziness, shakiness, hunger, weakness, and irritability are more commonly associated with hypoglycemia than a brisk jerk.
Which of the following tests should be used to make the diagnosis of Cushing's syndrome?
- A. 24-hour urine free cortisol
- B. Corticotropin-releasing hormone (CRH) level at 8 a.m.
- C. Inferior petrosal venous sampling
- D. Overnight 1-mg dexamethasone suppression test
Correct Answer: D
Rationale: The overnight 1-mg dexamethasone suppression test is commonly used as an initial screening test for Cushing's syndrome. In this test, a patient takes 1 mg of dexamethasone orally at 11 p.m., and their serum cortisol level is measured the next morning. In patients with Cushing's syndrome, the cortisol levels will not be suppressed by the dexamethasone due to the presence of excessive cortisol production.
Oxytocin:
- A. is not produced in males.
- B. inhibits lactation.
- C. stimulates smooth muscle contraction.
- D. is produced primarily in the SON in the hypothalamus.
Correct Answer: C
Rationale: Oxytocin is a hormone that is produced in both males and females. In females, oxytocin plays a crucial role in various physiological processes, notably during labor and childbirth. Oxytocin acts on the smooth muscles of the uterus, causing them to contract during labor (parturition) and helps in the ejection of milk during breastfeeding. This hormone is primarily synthesized in the paraventricular nucleus (PVN) and the supraoptic nucleus (SON) of the hypothalamus and stored in the posterior pituitary gland before being released into the bloodstream. Overall, oxytocin's main function is to stimulate smooth muscle contraction in the uterus and the mammary glands.
Which of the following is not a recognized feature of myxoedema?
- A. Ascites
- B. Cerebellar ataxia
- C. Increased incidence of pernicious anaemia
- D. Thyroid acropachy
Correct Answer: D
Rationale: Myxoedema is a severe form of hypothyroidism characterized by a range of symptoms and signs. Ascites, cerebellar ataxia, and increased incidence of pernicious anaemia are recognized features of myxoedema. However, thyroid acropachy is not a recognized feature of myxoedema. Thyroid acropachy is a condition characterized by clubbing of the fingers and toes, swelling of the hands and feet, and periosteal new bone formation, typically seen in patients with Graves' disease, which is a form of hyperthyroidism.