Nokea
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.
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Which of the following hormones are stored in the posterior pituitary gland?
- A. Prolactin
- B. Thyroid stimulating hormone (TSH)
- C. Growth hormone (GH)
- D. Adrenocorticotropic hormone (ACTH)
Correct Answer:
Rationale: Oxytocin and Vasopressin, also known as antidiuretic hormone (ADH), are the hormones stored in the posterior pituitary gland. These hormones are produced by the hypothalamus and then transported and stored in the posterior pituitary gland until they are released into the bloodstream when needed. Oxytocin plays a role in uterine contractions during childbirth and milk ejection during lactation, while Vasopressin regulates water balance in the body by acting on the kidneys to reduce urine production and conserve water. The other hormones listed, such as Prolactin, TSH, GH, ACTH, FSH, and LH, are produced by the anterior pituitary gland.
Regarding syndrome of inappropriate antidiuretic hormone (SIADH), which is true?
- A. Hyponatremia is dilutional
- B. Urine is relatively hypertonic to plasma
- C. ADH-mediated water reabsorption does not occur
- D. Renal function is jeopardized
Correct Answer: A
Rationale: In the syndrome of inappropriate antidiuretic hormone (SIADH), there is excessive secretion of antidiuretic hormone (ADH) leading to increased water reabsorption in the kidney tubules. This results in dilutional hyponatremia because the amount of water reabsorbed is greater than the electrolytes, such as sodium, leading to a relative decrease in their concentration in the blood. As a result, hyponatremia occurs in SIADH, contributing to symptoms such as nausea, confusion, and seizures due to the imbalance in electrolytes.
Pseudohypoparathyroidism is not associated with:
- A. Cataract
- B. Raised level of plasma PIH
- C. Mental retardation
- D. Reduced level of plasma phosphate
Correct Answer: B
Rationale: Pseudohypoparathyroidism is a rare genetic disorder that mimics the symptoms of hypoparathyroidism, despite normal or elevated levels of parathyroid hormone (PTH). The condition is characterized by hypocalcemia, hyperphosphatemia, and normal or elevated PTH levels. However, it is not associated with a raised level of plasma PIH (Parathyroid Inhibiting Hormone). In pseudohypoparathyroidism, the body's tissues are resistant to the action of PTH, leading to impaired calcium regulation. Other common features of pseudohypoparathyroidism may include cataract formation, mental retardation, and reduced levels of plasma phosphate.
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.
What is the most common cause of Cushing's syndrome?
- A. Ectopic ACTH production
- B. Adrenal adenoma
- C. Glucocorticoid treatment (iatrogenic)
- D. Pituitary adenoma
Correct Answer: D
Rationale: The most common cause of Cushing's syndrome is a pituitary adenoma, specifically a corticotroph adenoma. This adenoma leads to excessive secretion of adrenocorticotropic hormone (ACTH) by the pituitary gland, which in turn stimulates the adrenal glands to produce high levels of cortisol. This results in the symptoms and signs characteristic of Cushing's syndrome. Pituitary adenomas are responsible for around 70-80% of cases of Cushing's syndrome, making it the most common cause.