Nokea
Increased gonadal production of oestrogen is seen in:
- A. Third trimester of pregnancy
- B. Congenital adrenal hyperplasia
- C. Polycystic ovarian disease
- D. Testicular feminization syndrome
Correct Answer: C
Rationale: Polycystic ovarian disease, also known as polycystic ovary syndrome (PCOS), is a common endocrine disorder characterized by increased levels of androgens (male hormones) and disrupted estrogen production in the ovaries. The hormonal imbalance seen in PCOS leads to increased gonadal production of estrogen. This condition is often associated with symptoms such as irregular menstrual cycles, infertility, acne, and excess facial or body hair growth. In contrast, the other options do not typically involve increased gonadal production of estrogen as seen in PCOS.
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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.
Calcification of basal ganglia is seen in:
- A. Primary hyperparathyroidism
- B. Hypoparathyroidism
- C. Secondary hyperparathyroidism
- D. Milk-alkali syndrome
Correct Answer: A
Rationale: Primary hyperparathyroidism is a condition characterized by the overproduction of parathyroid hormone (PTH) by the parathyroid glands, leading to elevated levels of calcium in the blood. This excessive calcium can cause calcification in various tissues, including the basal ganglia of the brain. The calcification of the basal ganglia in primary hyperparathyroidism is a well-known radiological finding and can be visualized on imaging studies such as CT scans or MRI. Hypoparathyroidism, on the other hand, is characterized by low levels of PTH and results in decreased serum calcium levels, making it an unlikely cause of basal ganglia calcification. Secondary hyperparathyroidism is associated with chronic kidney disease and is also characterized by high PTH levels, but basal ganglia calcification is not a typical manifestation of this condition. Milk-alkali syndrome is a disorder characterized by excessive intake of
Sheehan's syndrome presents with:
- A. Cardiac failure
- B. Persistent lactation
- C. Fever
- D. Striking cachexia
Correct Answer: B
Rationale: Sheehan's syndrome, also known as postpartum hypopituitarism, is a condition characterized by pituitary gland dysfunction due to severe blood loss during childbirth, resulting in ischemic necrosis of the pituitary gland. As a consequence of pituitary hormone deficiency, one of the hallmark manifestations of Sheehan's syndrome is persistent lactation despite stopping breastfeeding. This occurs due to inadequate prolactin inhibition, leading to continuous milk production. Other common symptoms of Sheehan's syndrome include fatigue, weight loss, menstrual irregularities, hypothyroidism, adrenal insufficiency, and other pituitary hormone deficiencies. Cardiac failure, fever, and striking cachexia are not typical presentations associated with Sheehan's syndrome.
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.
All of the following represent examples of hypothalamic-pituitary negative feedback except:
- A. Cortisol on the CRH-ACTH axis
- B. Gonadal steroids on the GnRH-LH/FSH axis
- C. IGF-1 on the growth hormone-releasing hormone (GHRH)-GH axis
- D. Renin-angiotensin-aldosterone axis
Correct Answer: D
Rationale: The renin-angiotensin-aldosterone axis does not involve the hypothalamus or pituitary gland; instead, it primarily involves the kidneys and the renin-secreting cells. In this axis, renin is released in response to low blood pressure, leading to the formation of angiotensin II and the subsequent release of aldosterone from the adrenal glands. Feedback mechanisms for this axis primarily involve the regulation of renin release based on blood pressure rather than involving direct negative feedback from downstream hormones on the hypothalamus or pituitary gland. On the other hand, choices A, B, and C all involve classic examples of hypothalamic-pituitary negative feedback loops where the end hormone suppresses the release of the stimulating hormones at the hypothalamic and pituitary levels.