Nokea
Increased muscle mass with slowness of activity (Hoffman syndrome) is seen in:
- A. Acromegaly
- B. Myxoedema
- C. Pseudohypoparathyroidism
- D. Myotonia dystrophica
Correct Answer: A
Rationale: Acromegaly is a disorder caused by excessive growth hormone production by the pituitary gland in adults, leading to an increase in muscle mass (hypertrophy). Hoffman syndrome, characterized by increased muscle mass with slowness of activity, is a clinical feature often seen in individuals with acromegaly. The excessive growth hormone levels in acromegaly can cause acral growth, soft tissue swelling, and muscle hypertrophy, contributing to the characteristic features of the condition, including Hoffman syndrome. Therefore, the correct answer is Acromegaly.
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Which one of the following is acromegaly caused by?
- A. Overproduction of adrenocorticotropic hormone (ACTH)
- B. Overproduction of gonadotrophin releasing hormone (GnRH)
- C. Overproduction of growth hormone (GH)
- D. Overproduction of vasopressin (antidiuretic hormone)
Correct Answer: C
Rationale: Acromegaly is a disorder that is characterized by the overproduction of growth hormone (GH) by the pituitary gland in adults. This results in the abnormal growth of bones and tissues, leading to enlarged hands, feet, and facial features. The excess GH is usually caused by a pituitary tumor known as a somatotroph adenoma. This tumor causes the pituitary gland to produce excessive amounts of GH, which in turn leads to the symptoms associated with acromegaly. Treatment for acromegaly often involves surgical removal or reduction of the pituitary tumor, as well as medication to normalize GH levels.
All of the following are potential causes of elevated LDL , except:
- A. Cirrhosis
- B. Hypothyroidism
- C. Nephrotic syndrome
- D. Thiazide diuretics
Correct Answer: A
Rationale: Cirrhosis is not a potential cause of elevated LDL cholesterol levels. The liver plays a significant role in cholesterol metabolism, and liver disease like cirrhosis can actually lead to decreased levels of LDL cholesterol. Elevated LDL cholesterol levels can be caused by conditions such as hypothyroidism, nephrotic syndrome, or the use of certain medications like thiazide diuretics.
Aldosterone:
- A. is synthesized in the zona fasciculata.
- B. is deficient in Conn's syndrome.
- C. is independent of ACTH.
- D. is suppressed by elevated potassium.
Correct Answer: D
Rationale: Aldosterone is a hormone produced in the zona glomerulosa of the adrenal cortex, not the zona fasciculata (Choice A is incorrect). Conn's syndrome, also known as primary hyperaldosteronism, is characterized by excess aldosterone secretion, not a deficiency (Choice B is incorrect). Aldosterone production is under the control of the renin-angiotensin-aldosterone system, which is stimulated by factors such as low blood pressure, low blood volume, and high potassium levels. Elevated potassium in the blood directly suppresses aldosterone production by the adrenal glands, serving as a negative feedback mechanism to maintain electrolyte balance (Choice D is correct). The synthesis of aldosterone also requires cholesterol as the precursor, rather than pregnenolone (Choice E is incorrect). Lastly, aldosterone production is regulated in part by ACTH (adrenocorticotropic hormone), as it can enhance the effects of
Thyroid hormones (T3 and T4):
- A. increase metabolic rate.
- B. are hydrophilic as they are made from amino acids.
- C. contain iron atoms in ferrous form.
- D. stimulate the secretion of thyroid-stimulating hormone (TSH; thyrotropin).
Correct Answer: A
Rationale: Thyroid hormones, T3 (triiodothyronine) and T4 (thyroxine), play a crucial role in regulating metabolism in the body. They are responsible for increasing the metabolic rate of cells by influencing the production of proteins and controlling how the body uses energy. This increase in metabolic rate results in processes such as increased heart rate, enhanced nutrient breakdown, and higher body temperature. Thus, option A, "increase metabolic rate," is the correct statement regarding thyroid hormones (T3 and T4).
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.