All the following are risk factors for the development of osteoporotic fractures except
- A. African race
- B. Current cigarette smoking
- C. Female sex
- D. Physical inactivity
Correct Answer: A
Rationale: While African race is considered a protective factor against the development of osteoporosis due to higher peak bone mass and lower fracture rates compared to other races, the other factors listed (current cigarette smoking, female sex, and physical inactivity) are all established risk factors for the development of osteoporotic fractures. African-American individuals, in general, have a lower risk of osteoporosis and fractures compared to Caucasians and Asians.
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Which cranial nerve is not involved in acromegaly?
- A. VIII
- B. III, IV, VI
- C. V
- D. Il
Correct Answer: A
Rationale: Acromegaly is a disorder caused by the overproduction of growth hormone in adulthood, usually due to a pituitary tumor. The cranial nerves that may be affected in acromegaly are Cranial Nerves III, IV, VI (oculomotor, trochlear, abducens) due to compression of the optic chiasm by the expanding tumor. Cranial Nerve V (trigeminal nerve) may also be affected given its close proximity to the pituitary gland. However, Cranial Nerve VIII (vestibulocochlear nerve) is not typically involved in acromegaly.
Which of the following is not a neuromuscular feature of thyrotoxicosis?
- A. Myasthenic syndrome
- B. Brisk knee jerk
- C. Hypokalaemic periodic paralysis
- D. Hyperkinesia
Correct Answer: A
Rationale: Thyrotoxicosis typically presents with hypermetabolism and various neuromuscular manifestations. Myasthenic syndrome, which involves muscle weakness and fatigability, is not a common neuromuscular feature of thyrotoxicosis. Instead, manifestations such as brisk knee jerk reflexes, hypokalaemic periodic paralysis (due to shifts in potassium levels), and hyperkinesia (excessive movement) are more commonly observed in patients with thyrotoxicosis. Myasthenic syndrome is more commonly associated with autoimmune disorders affecting the neuromuscular junction, such as myasthenia gravis.
Which of the following is false regarding medullary carcinoma of thyroid?
- A. Cervical Iymphadenopathy
- B. High serum calcitonin
- C. Carcinoid syndrome may be associated with
- D. Psychosis
Correct Answer: D
Rationale: Medullary carcinoma of the thyroid typically presents with symptoms related to the thyroid gland itself, neck mass or swelling, and sometimes cervical lymphadenopathy. It is characterized by the production of calcitonin, leading to high serum calcitonin levels. Carcinoid syndrome, which includes symptoms such as flushing, diarrhea, and wheezing, is more commonly associated with neuroendocrine tumors, rather than medullary carcinoma of the thyroid. Psychosis is not a typical feature or manifestation of medullary carcinoma of the thyroid.
Which one of the following statements is true regarding the prevalence of acromegaly?
- A. Acromegaly affects a similar number of men and women
- B. Acromegaly affects twice as many women than men
- C. Acromegaly affects twice as many men than it does women
Correct Answer: C
Rationale: Acromegaly is a rare hormonal disorder where excess growth hormone is produced, leading to the enlargement of bones and tissues. The prevalence of acromegaly is higher in men compared to women, with a ratio of about two men affected for every woman. This gender difference is believed to be due to the impact of sex hormones on the development and progression of the condition. While acromegaly can affect both men and women, men are more commonly diagnosed with the disorder.
Which of the following is the most common cause of Cushing's disease?
- A. ACTH-producing pituitary adenoma
- B. Adrenocortical adenoma
- C. Ectopic ACTH secretion
- D. McCune-Albright syndrome
Correct Answer: A
Rationale: The most common cause of Cushing's disease is an ACTH-producing pituitary adenoma. In this condition, the pituitary gland produces excessive amounts of adrenocorticotropic hormone (ACTH), which stimulates the adrenal glands to produce high levels of cortisol. This leads to the signs and symptoms of Cushing's disease, such as weight gain, high blood pressure, and muscle weakness. Adrenocortical adenoma refers to a benign tumor of the adrenal cortex that can also cause Cushing's syndrome, but it is not as common as an ACTH-producing pituitary adenoma. Ectopic ACTH secretion occurs when a non-pituitary tumor produces ACTH, leading to Cushing's syndrome. McCune-Albright syndrome is a rare genetic disorder that can cause various endocrine abnormalities, but it is not a common cause of Cushing's disease.
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