Nokea
Commonest cause of Addison's disease is:
- A. Granuloma
- B. Idiopathic atrophy
- C. Inflammatory necrosis
- D. Malignancy
Correct Answer: A
Rationale: The most common cause of Addison's disease is autoimmune adrenalitis, also known as autoimmune adrenal insufficiency. In autoimmune adrenalitis, the adrenal glands are damaged by immune system-mediated processes, leading to their dysfunction. This autoimmune destruction typically presents as bilateral adrenal cortex atrophy due to the formation of granulomas. Therefore, the commonest cause of Addison's disease is the presence of granulomas in the adrenal glands, making option A, Granuloma, the correct choice.
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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.
Oxytocin:
- A. is bound to neurophysin in plasma.
- B. inhibits production of milk.
- C. inhibits myometrial contraction.
- D. inhibits sperm swimming on the gonad.
Correct Answer: A
Rationale: Oxytocin is a hormone produced by the hypothalamus and released by the pituitary gland. In the bloodstream, oxytocin is mostly bound to a carrier protein called neurophysin. This binding helps to protect oxytocin from being degraded too quickly in the bloodstream, thus allowing it to exert its effects on target tissues such as the uterus and mammary glands. Oxytocin plays important roles in stimulating uterine contractions during labor, facilitating milk letdown during breastfeeding, and promoting social bonding and emotional connections.
In a patient with centripetal obesity, acne and hirsutism. The most likely diagnosis is:
- A. Cushing's syndrome
- B. Diabetes mellitus
- C. Hypogonadism
- D. Hypothyroidism
Correct Answer: A
Rationale: Centripetal obesity, acne, and hirsutism are classic features of Cushing's syndrome. Cushing's syndrome results from prolonged exposure to high levels of cortisol, which can be due to various causes such as adrenal tumors, pituitary adenomas, or exogenous glucocorticoid use. Centripetal obesity refers to the characteristic fat distribution pattern seen in Cushing's syndrome, where fat accumulates mainly in the face, neck, and trunk while sparing the limbs. Acne and hirsutism are also commonly seen in Cushing's syndrome due to the hormonal imbalances caused by excess cortisol. Testing for serum cortisol levels, dexamethasone suppression tests, and imaging studies can help confirm the diagnosis of Cushing's syndrome in a patient presenting with these symptoms.
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.