Nokea
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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Which cranial nerve is not involved in acromegaly?
- A. VIII
- B. III, IV, VI
- C. V
- D. Il
Correct Answer: A
Rationale: Acromegaly is a disorder caused by the overproduction of growth hormone in adulthood, usually due to a pituitary tumor. The cranial nerves that may be affected in acromegaly are Cranial Nerves III, IV, VI (oculomotor, trochlear, abducens) due to compression of the optic chiasm by the expanding tumor. Cranial Nerve V (trigeminal nerve) may also be affected given its close proximity to the pituitary gland. However, Cranial Nerve VIII (vestibulocochlear nerve) is not typically involved in acromegaly.
Which of the following is false regarding medullary carcinoma of thyroid?
- A. Cervical Iymphadenopathy
- B. High serum calcitonin
- C. Carcinoid syndrome may be associated with
- D. Psychosis
Correct Answer: D
Rationale: Medullary carcinoma of the thyroid typically presents with symptoms related to the thyroid gland itself, neck mass or swelling, and sometimes cervical lymphadenopathy. It is characterized by the production of calcitonin, leading to high serum calcitonin levels. Carcinoid syndrome, which includes symptoms such as flushing, diarrhea, and wheezing, is more commonly associated with neuroendocrine tumors, rather than medullary carcinoma of the thyroid. Psychosis is not a typical feature or manifestation of medullary carcinoma of the thyroid.
Cortisol secretion is directly stimulated by:
- A. Aldosterone
- B. Prolactin
- C. ACTH
- D. CRH
Correct Answer: C
Rationale: Cortisol secretion is directly stimulated by adrenocorticotropic hormone (ACTH), which is produced and released by the anterior pituitary gland in response to corticotropin-releasing hormone (CRH) from the hypothalamus. ACTH acts on the adrenal cortex to stimulate the production and release of cortisol. Aldosterone is another hormone produced by the adrenal cortex, but it is not directly involved in the stimulation of cortisol secretion. Prolactin is a hormone produced by the pituitary gland that plays a role in lactation, not cortisol secretion. High blood potassium levels can stimulate aldosterone secretion but do not directly stimulate cortisol secretion.
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.
Which test is used to evaluate blood glucose levels over the previous 2 months?
- A. Methemoglobin
- B. Hemoglobin A1c
- C. Fasting blood sugar
- D. C peptide protein
Correct Answer: B
Rationale: Hemoglobin A1c, also known as HbA1c or glycated hemoglobin, is a blood test that measures the average blood glucose level over the previous 2 to 3 months. This test is useful in monitoring long-term blood glucose control in individuals with diabetes. Hemoglobin A1c provides an indication of how well blood glucose levels have been controlled over time, reflecting the average blood sugar levels during the lifespan of red blood cells, which is typically around 2 to 3 months. A higher Hemoglobin A1c level indicates poorer blood glucose control and an increased risk of diabetes complications.