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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Prolonged ingestion of iodine can produce goiter, and is known as:
- A. Jod-Basedow effect
- B. Sick euthyroid syndrome
- C. Wolf-Chaikoff effect
- D. Thyrotoxicosis factitia
Correct Answer: C
Rationale: The prolonged ingestion of iodine causing goiter is known as the Wolf-Chaikoff effect. This phenomenon occurs when high levels of iodine cause a temporary inhibition of thyroid hormone synthesis, resulting in a decrease in thyroid hormone production. In some individuals, this can lead to the development of a goiter due to the lack of thyroid hormone feedback regulation. It is important to note that the Wolf-Chaikoff effect typically resolves on its own as the thyroid gland adapts to the increased iodine levels over time.
Which one of the following is acromegaly caused by?
- A. Overproduction of adrenocorticotropic hormone (ACTH)
- B. Overproduction of gonadotrophin releasing hormone (GnRH)
- C. Overproduction of growth hormone (GH)
- D. Overproduction of vasopressin (antidiuretic hormone)
Correct Answer: C
Rationale: Acromegaly is a disorder that is characterized by the overproduction of growth hormone (GH) by the pituitary gland in adults. This results in the abnormal growth of bones and tissues, leading to enlarged hands, feet, and facial features. The excess GH is usually caused by a pituitary tumor known as a somatotroph adenoma. This tumor causes the pituitary gland to produce excessive amounts of GH, which in turn leads to the symptoms associated with acromegaly. Treatment for acromegaly often involves surgical removal or reduction of the pituitary tumor, as well as medication to normalize GH levels.
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.
Neurological features of myxoedema include all of the following except:
- A. Delayed relaxation of ankle jerk
- B. Cerebellar ataxia
- C. Hypertonia
- D. Bradylalia
Correct Answer: B
Rationale: Myxoedema refers to severe hypothyroidism which can lead to neurological manifestations. The correct features associated with myxoedema include delayed relaxation of ankle jerk (Choice A), hypertonia (Choice C), and bradylalia (Choice D). Cerebellar ataxia, which involves incoordination and balance issues due to dysfunction of the cerebellum, is not a typical neurological feature seen in myxoedema.
Which of the following are causes of nephrogenic diabetes insipidus?
- A. Sheehan's syndrome
- B. Lithium
- C. Mutations in the vasopressin (ADH) receptor gene
- D. Mutations in vasopressin gene
Correct Answer: B
Rationale: Nephrogenic diabetes insipidus (NDI) is a condition where the kidneys are unable to respond to antidiuretic hormone (ADH) as they should, leading to excessive urination and extreme thirst. One of the main causes of nephrogenic diabetes insipidus is the use of certain medications, with lithium being the most common culprit. Lithium can interfere with the kidney's response to ADH, resulting in decreased water reabsorption and the characteristic symptoms of diabetes insipidus. Other causes of NDI can include genetic mutations affecting the vasopressin receptor gene or other underlying conditions such as hypercalcemia, hypokalemia, or obstructive uropathy.