Nokea
Earliest changes observed by ophthalmoscope in background retinopathy of diabetes is:
- A. Venous dilatation
- B. Microaneurysms
- C. Increased capillary permeability
- D. Arteriovenous shunts
Correct Answer: B
Rationale: The earliest changes observed by ophthalmoscope in background retinopathy of diabetes is typically the presence of microaneurysms. These are small dilations of retinal capillaries due to weakening of the vessel walls caused by diabetes-induced damage. Microaneurysms are a hallmark sign of diabetic retinopathy and are often the first visible sign on retinal examination. Other changes in diabetic retinopathy, such as venous dilatation, increased capillary permeability, and arteriovenous shunts, may develop later in the disease process as it progresses.
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Which of the following tests should be used to make the diagnosis of Cushing's syndrome?
- A. 24-hour urine free cortisol
- B. Corticotropin-releasing hormone (CRH) level at 8 a.m.
- C. Inferior petrosal venous sampling
- D. Overnight 1-mg dexamethasone suppression test
Correct Answer: D
Rationale: The overnight 1-mg dexamethasone suppression test is commonly used as an initial screening test for Cushing's syndrome. In this test, a patient takes 1 mg of dexamethasone orally at 11 p.m., and their serum cortisol level is measured the next morning. In patients with Cushing's syndrome, the cortisol levels will not be suppressed by the dexamethasone due to the presence of excessive cortisol production.
Which of the following hormones are produced in the anterior pituitary gland?
- A. Oxytocin
- B. Prolactin
- C. Adrenocorticotrophic hormone (ACTH)
- D. Follicle-stimulating hormone (FSH)
Correct Answer: D
Rationale: Follicle-stimulating hormone (FSH) is one of the hormones produced in the anterior pituitary gland. The anterior pituitary gland secretes several hormones that regulate various functions in the body. FSH plays a crucial role in both males and females. In females, FSH stimulates the growth and maturation of ovarian follicles, which contain the eggs. In males, FSH is essential for the production of sperm in the testes. The production and release of FSH are regulated by the hypothalamus and gonadotropin-releasing hormone (GnRH).
Features of hypoglycaemia do not include:
- A. Drenching sweat
- B. Tachycardia
- C. Tachypnoea
- D. Brisk jerk
Correct Answer: D
Rationale: Hypoglycemia is characterized by a low blood sugar level, which can lead to various symptoms. The features of hypoglycemia typically include drenching sweat, tachycardia (increased heart rate), and tachypnea (rapid breathing). A brisk jerk, on the other hand, is not a typical feature of hypoglycemia. Symptoms such as confusion, dizziness, shakiness, hunger, weakness, and irritability are more commonly associated with hypoglycemia than a brisk jerk.
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.
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.