Nokea
All of the following are featured by dermal hyperpigmentation except:
- A. Conn's syndrome
- B. Bronchogenic carcinoma
- C. Addison's disease
- D. Haemochromatosis
Correct Answer: A
Rationale: Dermal hyperpigmentation, also known as hyperpigmentation of the skin, is commonly associated with conditions such as Addison's disease, hemochromatosis, and bronchogenic carcinoma. In Addison's disease, there is increased production of melanin due to elevated levels of adrenocorticotropic hormone (ACTH) which stimulates melanocytes. Hemochromatosis can cause hyperpigmentation due to excess iron deposits in the skin. Bronchogenic carcinoma can lead to a condition known as acanthosis nigricans, characterized by dark, velvety discoloration of the skin primarily around the neck and armpits. However, Conn's syndrome, which is a primary aldosteronism resulting from an adrenal adenoma or hyperplasia, is not typically associated with dermal hyperpigmentation.
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Which of the following are not causes of neurogenic diabetes insipidus?
- A. Sheehan's syndrome
- B. Mutations in the vasopressin (ADH) receptor gene
- C. Meningitis
- D. Mutations in the vasopressin gene
Correct Answer: D
Rationale: Neurogenic diabetes insipidus is due to a deficiency in vasopressin (antidiuretic hormone, ADH) production in the hypothalamus or a failure of proper vasopressin release from the posterior pituitary. Causes of neurogenic DI typically involve factors affecting vasopressin synthesis, storage, or release. However, mutations in the vasopressin gene itself would be a cause of genetic forms of diabetes insipidus, not neurogenic diabetes insipidus. Common causes of neurogenic diabetes insipidus include traumatic brain injury, brain tumors, pituitary adenomas, meningitis, and Sheehan's syndrome.
Commonest cause of 'ambiguous genitalia' in newborn is:
- A. Congenital adrenal hyperplasia
- B. True hermaphroditism
- C. Testicular ferminisation syndrome
- D. Pseudo-hermaphroditism
Correct Answer: A
Rationale: Congenital adrenal hyperplasia (CAH) is the most common cause of ambiguous genitalia in newborns. This condition is due to a deficiency of enzymes in the adrenal gland that are necessary for the production of cortisol. As a result, the body produces excess androgens (masculinizing hormones), leading to abnormal genital development in females. The external genitalia may appear ambiguous, with features of both male and female genitalia. This condition can be detected through newborn screening and confirmed through further hormonal and genetic testing. Treatment involves hormone replacement therapy to normalize hormone levels and surgery may be required to reconstruct the genitalia.
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.
All of the following are potential signs or symptoms of growth hormone deficiency except:
- A. Abnormal lipid profile
- B. Atherosclerosis
- C. Increased bone mineral density
- D. Left ventricular dysfunction
Correct Answer: C
Rationale: Growth hormone deficiency (GHD) is commonly associated with decreased bone mineral density, leading to an increased risk of fractures and osteoporosis. Therefore, increased bone mineral density would not typically be a sign or symptom of GHD. On the other hand, abnormal lipid profile, atherosclerosis, and left ventricular dysfunction are all potential signs or symptoms of GHD. Abnormal lipid profile can manifest as increased levels of LDL cholesterol and decreased levels of HDL cholesterol. Atherosclerosis, the buildup of plaque in the arteries, can occur in individuals with GHD due to the impact on lipid metabolism. Left ventricular dysfunction may also be seen in individuals with GHD due to the role of growth hormone in cardiac function and structure.
Which of the following statements best describes Cushing's syndrome?
- A. Cushing's syndrome refers to a disease process caused by abnormally high levels of cortisol
- B. Cushing's syndrome refers to a disease process caused by abnormally low levels of aldosterone
- C. Cushing's syndrome refers to a disease process caused by abnormally high levels of aldosterone
- D. Cushing's syndrome refers to a disease process caused by abnormally low levels of cortisol
Correct Answer: A
Rationale: Cushing's syndrome is a condition characterized by excessive levels of cortisol in the body. Cortisol is a hormone produced by the adrenal glands that helps regulate various bodily functions, including metabolism, immune response, and stress response. When there is an overproduction of cortisol, either due to excessive production by the adrenal glands or prolonged use of corticosteroid medications, it can result in Cushing's syndrome. Symptoms of Cushing's syndrome include weight gain, particularly in the face and abdomen, high blood pressure, muscle weakness, and irregularities in menstruation. It is important to diagnose and manage Cushing's syndrome to prevent potential complications such as diabetes, osteoporosis, and cardiovascular disease.