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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Commonest enzymatic defect for development of congenital adrenal hyperplasia is:
- A. C-21 hydroxylase deficiency
- B. 3b dehydrogenase deficiency
- C. C-11 hydroxylase deficiency
- D. C-17 hydroxylase deficiency
Correct Answer: A
Rationale: C-21 hydroxylase deficiency is the most common enzymatic defect leading to the development of congenital adrenal hyperplasia (CAH). This enzyme is necessary for the synthesis of cortisol and aldosterone in the adrenal glands. When there is a deficiency in C-21 hydroxylase, the pathway is shifted towards the production of androgens instead of cortisol and aldosterone, leading to excess androgen production. This results in the characteristic features of CAH, such as ambiguous genitalia in females and virilization in both males and females. Other enzyme deficiencies listed in the choices can also lead to different types of CAH but are less common compared to C-21 hydroxylase deficiency.
Myxoedema is characterized by all except:
- A. Butterfly rash in face
- B. Sinus bradycardia
- C. Solid oedema
- D. Madarosis
Correct Answer: A
Rationale: Myxoedema is a term used to describe severe hypothyroidism. The characteristic features of myxoedema include sinus bradycardia (choice B), solid oedema (choice C), and madarosis (choice D), which refers to loss of eyebrows and eyelashes. However, a butterfly rash is not a typical feature of myxoedema. A butterfly rash is commonly associated with conditions like systemic lupus erythematosus rather than myxoedema.
Obesity is associated with an increased incidence of all the following except
- A. Diabetes mellitus
- B. Cancer
- C. Hypertension
- D. Chronic obstructive lung disease
Correct Answer: D
Rationale: Obesity is associated with an increased risk of developing various health conditions, including diabetes mellitus, cancer, and hypertension. However, chronic obstructive lung disease (COPD) is not directly linked to obesity. COPD is primarily caused by exposure to harmful particles or gases, most commonly from cigarette smoke. While obesity can impact lung function and worsen symptoms in individuals with COPD, it is not a direct cause of the condition. Therefore, the correct answer is D, chronic obstructive lung disease.
Which of the following statements best describes Hashimoto's thyroiditis?
- A. Inflammation of the thyroid gland as the result of a virus. The disease is often preceded by an upper respiratory tract infection.
- B. A destructive autoimmune disease caused by auto-reactive antibodies against thyroglobulin.
- C. Iodine deficiency
- D. thyroid gland
Correct Answer: B
Rationale: Hashimoto's thyroiditis is an autoimmune disease where the immune system mistakenly attacks the thyroid gland. The antibodies produced by the immune system target the thyroglobulin in the thyroid gland, leading to its destruction over time. This results in decreased thyroid hormone production, leading to hypothyroidism. Therefore, choice B, "A destructive autoimmune disease caused by auto-reactive antibodies against thyroglobulin," best describes Hashimoto's thyroiditis.
Which of the following lung cancers is most commonly associated with the syndrome of inappropriate secretion of antidiuretic hormone (SIADH)?
- A. Squamous cell carcinoma
- B. Small cell (oat cell) carcinoma
- C. Large cell carcinoma
- D. Adenocarcinoma
Correct Answer: B
Rationale: Small cell (oat cell) carcinoma of the lung is most commonly associated with the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). This paraneoplastic syndrome occurs in patients with small cell lung cancer due to the production of antidiuretic hormone (ADH) by the tumor cells. The excessive release of ADH leads to water retention and dilutional hyponatremia, causing symptoms such as nausea, confusion, seizures, and potentially life-threatening complications. Other types of lung cancer, such as squamous cell carcinoma, large cell carcinoma, and adenocarcinoma, are less commonly associated with SIADH.