Nokea
All the following drugs are associated with an increased risk of osteoporosis in adults except:
- A. Cyclosporine
- B. Heparin
- C. Prednisone
- D. Ranitidine
Correct Answer: D
Rationale: Ranitidine is not associated with an increased risk of osteoporosis in adults. It is a histamine-2 blocker commonly used to reduce stomach acid production and treat conditions such as ulcers and gastroesophageal reflux disease. On the other hand, the other options listed are known to increase the risk of osteoporosis:
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Increased muscle mass with slowness of activity (Hoffman syndrome) is seen in:
- A. Acromegaly
- B. Myxoedema
- C. Pseudohypoparathyroidism
- D. Myotonia dystrophica
Correct Answer: A
Rationale: Acromegaly is a disorder caused by excessive growth hormone production by the pituitary gland in adults, leading to an increase in muscle mass (hypertrophy). Hoffman syndrome, characterized by increased muscle mass with slowness of activity, is a clinical feature often seen in individuals with acromegaly. The excessive growth hormone levels in acromegaly can cause acral growth, soft tissue swelling, and muscle hypertrophy, contributing to the characteristic features of the condition, including Hoffman syndrome. Therefore, the correct answer is Acromegaly.
Anti-diuretic hormone secretion is:
- A. increased during stress.
- B. reduced during hemorrhage.
- C. reduced by increased blood osmolality.
- D. increased by alcohol.
Correct Answer: B
Rationale: Anti-diuretic hormone (ADH), also known as vasopressin, is a hormone released by the pituitary gland in response to changes in blood osmolality, blood volume, and blood pressure. During hemorrhage (significant blood loss), the body experiences a decrease in blood volume and blood pressure. In response to this decrease in blood volume, ADH secretion is increased to help the body retain water and maintain blood pressure levels. Therefore, it is incorrect to say that ADH secretion is reduced during hemorrhage.
Phaeochromocytoma is not associated with:
- A. Weight gain
- B. Fear of death (angor animi)
- C. Paroxysmal hypertension
- D. Constipation
Correct Answer: A
Rationale: Phaeochromocytoma is a rare neuroendocrine tumor that usually originates from the adrenal glands and produces excess catecholamines. The characteristic symptoms of phaeochromocytoma include paroxysmal (sudden and severe) hypertension, fear of impending death (angor animi), and episodic symptoms like palpitations, headache, and diaphoresis. However, weight gain is not a typical manifestation associated with phaeochromocytoma. In fact, patients with this condition may experience unintentional weight loss due to the effects of excess catecholamines on metabolism and appetite suppression. Therefore, weight gain is not a significant feature observed in individuals with phaeochromocytoma.
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.
Which of the following are signs of acromegaly?
- A. Increased jaw prominence
- B. Enlargement of feet
- C. Enlargement of the hands and fingers
- D. Decrease in tongue size (microglossia)
Correct Answer: A
Rationale: Acromegaly is a disorder characterized by excess growth hormone production, usually due to a pituitary adenoma. Signs and symptoms of acromegaly arise gradually over time due to excess growth hormone leading to tissue overgrowth.