Commonest cause of 'ambiguous genitalia' in newborn is:
- A. Congenital adrenal hyperplasia
- B. True hermaphroditism
- C. Testicular ferminisation syndrome
- D. Pseudo-hermaphroditism
Correct Answer: A
Rationale: Congenital adrenal hyperplasia (CAH) is the most common cause of ambiguous genitalia in newborns. This condition is due to a deficiency of enzymes in the adrenal gland that are necessary for the production of cortisol. As a result, the body produces excess androgens (masculinizing hormones), leading to abnormal genital development in females. The external genitalia may appear ambiguous, with features of both male and female genitalia. This condition can be detected through newborn screening and confirmed through further hormonal and genetic testing. Treatment involves hormone replacement therapy to normalize hormone levels and surgery may be required to reconstruct the genitalia.
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What is the most common cause for the overproduction of growth hormone in acromegaly?
- A. Hypothalamic lesion
- B. Hyperplasia of the pituitary stalk
- C. Pituitary lesion
- D. Pituitary adenoma
Correct Answer: D
Rationale: Acromegaly is typically caused by the overproduction of growth hormone (GH) by the pituitary gland. In around 95% of cases, this overproduction is due to the presence of a non-cancerous tumor called a pituitary adenoma. These adenomas are benign, slow-growing tumors that cause the pituitary gland to produce excessive amounts of growth hormone, leading to the characteristic symptoms of acromegaly such as enlargement of the bones and soft tissues.
All of the following are noted in Cushing's syndrome except:
- A. Psychosis
- B. Systemic hypertension
- C. Sexual precocity
- D. Osteoporosis
Correct Answer: C
Rationale: Cushing's syndrome is a collection of signs and symptoms caused by prolonged exposure to high levels of cortisol. Common features of Cushing's syndrome include weight gain, central obesity, moon face, buffalo hump, easy bruising, muscle weakness, and menstrual irregularities in women.
The posterior pituitary stores and secretes _________.
- A. anti-diuretic hormone (ADH) and oxytocin.
- B. growth hormone and thyroid-stimulating hormone.
- C. estrogen and testosterone.
- D. aldosterone and cortisol.
Correct Answer: A
Rationale: The posterior pituitary gland secretes anti-diuretic hormone (ADH) and oxytocin, which are produced in the hypothalamus and then transported and stored in the posterior pituitary before being released into the bloodstream. ADH, also known as vasopressin, helps regulate water balance in the body by controlling the reabsorption of water in the kidneys. Oxytocin, on the other hand, plays a role in various reproductive functions such as labor and lactation, as well as social bonding and behavior.
All the following are risk factors for the development of osteoporotic fractures except
- A. African race
- B. Current cigarette smoking
- C. Female sex
- D. Physical inactivity
Correct Answer: A
Rationale: While African race is considered a protective factor against the development of osteoporosis due to higher peak bone mass and lower fracture rates compared to other races, the other factors listed (current cigarette smoking, female sex, and physical inactivity) are all established risk factors for the development of osteoporotic fractures. African-American individuals, in general, have a lower risk of osteoporosis and fractures compared to Caucasians and Asians.
Thyrotoxicosis may be featured by all except:
- A. Myopathy
- B. Pretibial myxoedema
- C. Hypernatraemia
- D. Atrial fibrillation
Correct Answer: A
Rationale: Thyrotoxicosis, also known as hyperthyroidism, is a condition characterized by excessive thyroid hormone production by the thyroid gland. Symptoms of thyrotoxicosis can include weight loss, heat intolerance, tremors, hyperactivity, and fatigue. While musculoskeletal symptoms such as weakness and tremors are common in thyrotoxicosis, true myopathy (muscle disease) is not a typical feature of the condition. Therefore, myopathy is the correct choice among the given options.