All of the following would be expected to increase prolactin levels except:
- A. Chest wall trauma
- B. Hyperthyroidism
- C. Pregnancy
- D. Renal failure
Correct Answer: B
Rationale: Prolactin levels can be increased by various factors, including chest wall trauma, pregnancy, and renal failure. However, hyperthyroidism is not typically associated with elevated prolactin levels. In fact, hyperthyroidism is more commonly associated with decreased levels of prolactin due to the inhibitory effect of thyroid hormones on prolactin secretion. Therefore, all of the options except for hyperthyroidism would be expected to increase prolactin levels.
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Which of the following is not a symptom of Cushing's syndrome?
- A. Easy bruising
- B. Weight gain
- C. Acne
- D. Weight loss
Correct Answer: D
Rationale: Weight gain is a common symptom of Cushing's syndrome due to the excessive production of cortisol, a hormone that regulates metabolism and fat storage. The other symptoms listed, such as easy bruising, acne, and stretch marks, are also characteristic features of Cushing's syndrome. However, weight loss is typically not associated with this condition. In fact, individuals with Cushing's syndrome often experience unexplained and rapid weight gain, especially in the face, abdomen, and upper back (resulting in a characteristic "buffalo hump" appearance), rather than weight loss.
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.
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.
Persistent muscular weakness is characteristic of:
- A. Conn's syndrome
- B. Acromegaly
- C. Hyperparathyroidism
- D. Myxoedema
Correct Answer: D
Rationale: Persistent muscular weakness is characteristic of myxoedema, which is severe hypothyroidism. Myxoedema can lead to general weakness and fatigue, as thyroid hormones play a crucial role in controlling metabolism and energy production in the body. Other symptoms of myxoedema include cold intolerance, weight gain, dry skin, and hair loss. Conn's syndrome (hyperaldosteronism) is characterized by hypertension and low potassium levels, not persistent muscular weakness. Acromegaly is a condition resulting from excess growth hormone production, leading to enlarged body parts and metabolic changes but not specifically muscular weakness. Hyperparathyroidism is associated with high levels of parathyroid hormone, which can lead to bone weakening and calcium imbalance, but it is not typically a primary cause of muscular weakness.
Which of the following is the underlying problem in neurogenic diabetes insipidus?
- A. Overproduction of vasopressin (antidiuretic hormone)
- B. Lack of oxytocin
- C. Overproduction of oxytocin
- D. Overproduction of prolactin
Correct Answer: E
Rationale: Neurogenic diabetes insipidus is a condition characterized by a deficiency of vasopressin (antidiuretic hormone). Vasopressin is responsible for regulating the body's water balance by controlling the reabsorption of water in the kidneys. In neurogenic diabetes insipidus, there is a problem with either the production, release, or action of vasopressin, leading to excessive urination and thirst. This condition can be caused by damage to the hypothalamus or pituitary gland, which are involved in producing and releasing vasopressin. Symptoms of neurogenic diabetes insipidus include frequent urination, excessive thirst, and dehydration.
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